Individual
KATE ERICA BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1015 MEYER RD, WENTZVILLE, MO 63385-3457
(636) 265-1505
(636) 266-2112
Mailing address
2315 HIGHWAY K, O FALLON, MO 63368-8659
(636) 265-1505
(636) 266-2112
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2008005693
MO
Other
Enumeration date
10/20/2010
Last updated
05/20/2019
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