Individual
GEORGE THOMAS BLEVINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
422 N 1ST ST, SHELTON, WA 98584-3410
(360) 426-6325
(360) 426-8300
Mailing address
PO BOX 1975, SHELTON, WA 98584-5030
(360) 426-6325
(360) 426-8300
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00034351
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
187046
L & I NUMBER
WA
01
—
20-4226795
FEDERAL TAX ID
WA
Enumeration date
12/22/2006
Last updated
05/16/2013
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