Individual
BLAKE CARLTON AUSENHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
112 JJ CIR, NORA SPRINGS, IA 50458-8611
(641) 420-4573
Mailing address
112 JJ CIR, NORA SPRINGS, IA 50458-8611
(641) 420-4573
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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