Individual
JAMIE BLACKIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1901 LOUISIANA ST, LAWRENCE, KS 66046-2938
(918) 638-7807
Mailing address
128 NELSON CIR, OLATHE, KS 66061-7608
(918) 638-7807
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00996
KS
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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