Individual
JARED ALLEN BLANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
8726 US 42, FLORENCE, KY 41042
(859) 301-2663
(859) 817-7848
Mailing address
560 S LOOP RD, EDGEWOOD, KY 41017-3405
(859) 817-4277
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
008255
KY
2251X0800X
Orthopedic Physical Therapist
PT019230
OH
Other
Enumeration date
05/28/2021
Last updated
05/28/2021
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