Individual
KELLY JEAN BLAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3680 SELMA RD, SPRINGFIELD, OH 45502-6310
(937) 328-5378
(937) 328-5379
Mailing address
3680 SELMA RD, SPRINGFIELD, OH 45502-6310
(937) 328-5378
(937) 328-5379
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT8960
OH
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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