Individual
BLAISE JUNIOR NZOUKOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8000 YORK RD, TOWSON, MD 21252-0001
(301) 586-2571
Mailing address
8000 YORK RD, TOWSON, MD 21252-0001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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