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NPI Code Detail

MEDICARE: TIFFINIE BLAYLOCK

MEDICARE:   TIFFINIE  BLAYLOCK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1730885583
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFINIE BLAYLOCK
Provider Business Mailing Address
First Line : 238 RIFFES BR
Second Line :
City : RHODELL
State : WV
Zip : 25915-9101
Country : US
Telephone Number : 304-683-4828
Fax Number :
Provider Business Practice Location Address
First Line : 238 RIFFES BR
Second Line :
City : RHODELL
State : WV
Zip : 25915-9101
Country : US
Telephone Number : 304-683-4828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2023
Last Update Date : 02/03/2023

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Directions to “ TIFFINIE BLAYLOCK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.