Individual
KEVIN BLASCZIENSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12737 SWEET BAY DR, EULESS, TX 76040-3440
(716) 491-9193
Mailing address
12737 SWEET BAY DR, EULESS, TX 76040-3440
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5135
TX
Other
Enumeration date
03/16/2016
Last updated
03/16/2016
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