Individual
STEPHANIE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
264 HOLDEN LN, JOHNSTOWN, CO 80534-9452
(505) 860-7093
Mailing address
264 HOLDEN LN, JOHNSTOWN, CO 80534-9452
(505) 860-7093
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013285
CO
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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