Individual
JACOB AXL BLOTSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
210 ELM ST NORTH, FARGO, ND 58102
(701) 232-3241
Mailing address
1217 30TH AVE W, WEST FARGO, ND 58078-7940
(701) 541-2557
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
R-1575
ND
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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