Individual
BLAKE BLUNDRED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
8651 JOHN T WHITE RD STE 121, FORT WORTH, TX 76120-2766
(817) 542-0714
Mailing address
3914 ESCOBA DR, GRAND PRAIRIE, TX 75052-6826
(469) 407-9176
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1406802
TX
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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