Individual
MS. PAMELA GAIL BLAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1411 OAK KNOLL DR, BARDSTOWN, KY 40004-9345
(502) 348-1925
Mailing address
1411 OAK KNOLL DR, BARDSTOWN, KY 40004-9345
(502) 348-1925
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
KY0039
KY
Other
Enumeration date
05/21/2010
Last updated
05/21/2010
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