Individual
MR. THOMAS GERALD BLAKESLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1800 CAMPUS CENTER DR, HPER WEST, SALT LAKE CITY, UT 84112
(302) 220-1247
Mailing address
325 S ORCHARD DR APT D309, NORTH SALT LAKE, UT 84054-1873
(302) 220-1247
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
12937807-4810
UT
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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