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Individual

JACOB SAMUEL BLITSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1001 E LEIGH ST, RICHMOND, VA 23298-5004
(804) 828-9783
Mailing address
PO BOX 980257, RICHMOND, VA 23298-0257
(804) 828-9783

Taxonomy

Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
390200000X
Student in an Organized Health Care Education/Training Program
Primary
1346915378
VA

Other

Enumeration date
08/11/2021
Last updated
06/25/2024
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