Individual
DR. BLAZE CHARLES CHATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, CSCS
Contact information
Practice address
141 MAIN ST, MILFORD, MA 01757-2613
(508) 422-0101
Mailing address
NAVY MEDICAL CENTER 100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547
(910) 440-2619
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
20604
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
890178155
THE EMPIRE PLAN
NY
Enumeration date
08/01/2013
Last updated
02/08/2024
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