Individual
MRS. CAROLYN GWENDOLYN BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
445 RICHARDSON RD, LAFAYETTE, TN 37083-3813
(615) 699-2495
Mailing address
445 RICHARDSON RD, LAFAYETTE, TN 37083-3813
(615) 699-2495
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
478
TN
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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