person
John Luther Blaylock
Mental Health Clinic/Center (Including Community Mental Health Center) in Phoenix, Arizona
NPI 1467129478

John Luther Blaylock is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Phoenix, AZ and is specialized in Mental Health (Including Community Mental Health Center). John Luther Blaylock practices in Phoenix, AZ. The NPI Number for John Luther Blaylock is 1467129478 and holds a License No. (Arizona).

The current practice location address for John Luther Blaylock is 2432 W Peoria Ave, Phoenix, AZ and can be reached out via phone at 480-431-5075.

Location: 2432 W Peoria Ave, Phoenix, AZ, 85029-4726
person
Provider Profile Details
NPI Number
1467129478
Provider Name
John Luther Blaylock
Credential
Provider Entity Type
Individual
Gender
Male
Address
2432 W Peoria Ave, Phoenix, AZ, 85029-4726
Phone Number
480-431-5075
Fax Number
Provider Enumeration Date
08/26/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
NA 01 NA
institution
Provider Business Practice Location Address Details
Address
2432 W Peoria Ave
City
State
Zip
85029-4726
Phone Number
480-431-5075
Fax Number
person
Provider Business Mailing Address Details
Address
2432 W Peoria Ave
City
State
Zip
85029-4726
Phone Number
480-431-5075
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
()
Definition
Definition to come...
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