Individual
DR. SAMANTHA ANN BLANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2174 DIXIE HWY, FT MITCHELL, KY 41017-2972
(859) 341-2566
Mailing address
3405 WOODLAND DR, MANITOWOC, WI 54220-9664
(920) 905-2836
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ATI4665
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2023
Last updated
07/18/2024
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