Individual
KRISTEN N BLENCOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 233-4082
Mailing address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 233-4082
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MA054685
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA054685
PA STATE LICENSE
PA
Enumeration date
10/15/2010
Last updated
10/15/2010
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