Individual
BLAINE ANTHONY BIRTZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DAT, LAT, ATC
Contact information
Practice address
1536 HEWITT AVE, SAINT PAUL, MN 55104-1284
(651) 523-3094
Mailing address
1536 HEWITT AVE, SAINT PAUL, MN 55104-1205
(715) 214-3898
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/22/2016
Last updated
08/12/2025
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