Individual
STEVEN BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
4604 LOWE RD, LOUISVILLE, KY 40220-1514
(502) 403-1620
Mailing address
4604 LOWE RD, LOUISVILLE, KY 40220-1514
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005975
KY
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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