Individual
IAN KORNBLUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
800 BUNN DR STE 102, PRINCETON, NJ 08540-1968
(800) 455-8982
(609) 644-3817
Mailing address
21416 N 38TH PL, PHOENIX, AZ 85050-4969
(609) 651-3155
(609) 644-3817
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA00849800
NJ
225100000X
Physical Therapist
Primary
LPT-013539
AZ
Other
Enumeration date
01/16/2007
Last updated
10/20/2019
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