Individual
MR. BLAIR THOMAS GORSUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
6501 N SHERIDAN RD, PEORIA, IL 61614-2932
(309) 621-4106
(309) 621-4194
Mailing address
6501 N SHERIDAN RD, PEORIA, IL 61614-2932
(309) 621-4106
(309) 621-4194
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
—
—
Other
Enumeration date
11/20/2013
Last updated
11/20/2013
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