Individual
BENJAMIN BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1705 BOW ST, MISSOULA, MT 59801-5652
(406) 549-5283
Mailing address
600 EVANS AVE, MISSOULA, MT 59801-5824
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24307
MT
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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