Individual
DR. MICHAEL RAY BLANKENSHIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, MS, ATC/LAT
Contact information
Practice address
8701 S HARDY DR, TEMPE, AZ 85284-2800
(160) 237-9171
Mailing address
8701 S HARDY DR, TEMPE, AZ 85284-2800
(160) 237-9171
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
10754
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T64322062
PHYSICAL THERAPY, ATHLETIC TRAINER
AZ
Enumeration date
02/07/2014
Last updated
02/07/2014
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