Provider Demographics
NPI:1386859312
Name:BLATTERMAN, ALAN LEE (OD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:LEE
Last Name:BLATTERMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2417 CHRIS DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5537
Mailing Address - Country:US
Mailing Address - Phone:931-920-5383
Mailing Address - Fax:
Practice Address - Street 1:2315 MADISON ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5454
Practice Address - Country:US
Practice Address - Phone:931-647-9411
Practice Address - Fax:931-552-9108
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNOD-T1969152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist