Individual
PATRICIA DIANE BLASICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1508 TOMBRAS AVE, EAST RIDGE, TN 37412-2720
(423) 867-4969
(423) 867-4971
Mailing address
1508 TOMBRAS AVE, EAST RIDGE, TN 37412-2720
(423) 867-4969
(423) 867-4971
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1390
TN
Other
Enumeration date
07/30/2008
Last updated
04/16/2019
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