Individual
JACOB THOMAS BLONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1451 HIGHWAY 2, TWO HARBORS, MN 55616-4049
(218) 834-2586
(218) 834-2587
Mailing address
1451 HIGHWAY 2, TWO HARBORS, MN 55616-4049
(218) 834-2586
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11860
MN
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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