Individual
ERNEST BLITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1604 NORTH MAIN, MOUNTAIN GROVE, MO 65711-1010
(417) 926-6563
Mailing address
510 EAST 7TH STREET, MOUNTAIN GROVE, MO 65711-1811
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
2011019352
MO
Other
Enumeration date
12/09/2011
Last updated
12/09/2011
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