Individual
BLAKE EUGENE STELZRIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
759 SCHROLL CT, FORSYTH, IL 62535-9600
(217) 620-9169
Mailing address
759 SCHROLL CT, FORSYTH, IL 62535-9600
(217) 620-9169
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
02/24/2015
Last updated
06/30/2016
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