Individual
DR. KEITH BRADLEY BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS, ATC
Contact information
Practice address
825 CENTENNIAL DR, CHADRON, NE 69337-9400
(308) 432-0232
(308) 432-0268
Mailing address
825 CENTENNIAL DR, CHADRON, NE 69337-9400
(308) 432-0232
(308) 432-0268
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1059
NE
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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