Provider Demographics
NPI:1124400577
Name:BLACKWOOD, SIARA LEONE (RDMS, RVT)
Entity Type:Individual
Prefix:MS
First Name:SIARA
Middle Name:LEONE
Last Name:BLACKWOOD
Suffix:
Gender:F
Credentials:RDMS, RVT
Other - Prefix:MS
Other - First Name:SIARA
Other - Middle Name:LEONE
Other - Last Name:COWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:77 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1941
Mailing Address - Country:US
Mailing Address - Phone:828-772-8869
Mailing Address - Fax:
Practice Address - Street 1:77 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1941
Practice Address - Country:US
Practice Address - Phone:828-772-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1838712471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography