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Individual

JENNA AMBER BLANCHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2333 CAMINO DEL RIO S, 240, SAN DIEGO, CA 92108-3607
(619) 715-5180
Mailing address
12345 LAKESHORE DR APT 22, LAKESIDE, CA 92040-3047
(619) 715-5180

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
21298
CA
225700000X
Massage Therapist
Primary
21298
CA

Other

Enumeration date
10/18/2011
Last updated
10/18/2011
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