Individual
TRE ALAN BLACKFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
701 RIVERVIEW ST, DES MOINES, IA 50316-2343
(515) 266-1106
Mailing address
9816 LAGUNA DR, JOHNSTON, IA 50131-2998
(641) 751-0027
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
101467
IA
Other
Enumeration date
02/19/2021
Last updated
02/19/2021
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