Individual
DANIEL BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
110 HIGHLAND AVE, CIRCLEVILLE, OH 43113-1208
(740) 500-1402
Mailing address
110 HIGHLAND AVE, CIRCLEVILLE, OH 43113-1208
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
171766
OH
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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