Individual
MR. DAVID A BLISSENBACH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 N 8TH ST, E ST LOUIS, IL 62201-2989
(618) 274-2020
Mailing address
19 DELANO DR, CAHOKIA, IL 62206-3105
(618) 337-1500
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371210755001
—
IL
Enumeration date
06/06/2006
Last updated
04/26/2026
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