Individual
MARY BLOCHBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, ATC, LAT
Contact information
Practice address
1432 SOUTHWEST BLVD, JEFFERSON CITY, MO 65109-2444
(573) 632-5614
Mailing address
12813 BRUSH CREEK RD, RUSSELLVILLE, MO 65074-2742
(573) 338-2333
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/29/2018
Last updated
12/29/2018
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