Individual
MRS. JENNIFER L BLANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2814 S BALTIMORE ST, KIRKSVILLE, MO 63501
(660) 785-1834
Mailing address
2814 S BALTIMORE ST, KIRKSVILLE, MO 63501-4640
(660) 785-1834
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
117394
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
481363000
—
MO
Enumeration date
03/28/2007
Last updated
07/03/2018
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