Individual
MARK D BLAZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3250 HARDEN STREET EXT, SUITE 100, COLUMBIA, SC 29203-6842
(803) 509-6389
(803) 509-6390
Mailing address
10 WILLIAM POPE DR, SUITE 3, BLUFFTON, SC 29909-7549
(843) 705-9440
(843) 705-9445
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7901
SC
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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