Individual
ERIC BLANKENHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1650 TRI PARK WAY, SUITE A, APPLETON, WI 54914-1601
(920) 830-6697
(920) 830-6707
Mailing address
1650 TRI PARK WAY, SUITE A, APPLETON, WI 54914-1601
(920) 830-6697
(920) 830-6707
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1129-026
WI
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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