Individual
MS. MAXINE AMA BLOHOWIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
675 E BROAD ST, BETHLEHEM, PA 18018-6332
(920) 264-2065
Mailing address
3171 MOLLY BROWN LN, GREEN BAY, WI 54313-7300
(920) 264-2065
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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