Individual
TAMRA BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPTA
Contact information
Practice address
15319 W 95TH ST, LENEXA, KS 66219-1262
(913) 495-9905
Mailing address
28035 AVENUE STANFORD, VALENCIA, CA 91355-1104
(661) 678-6726
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-03213
KS
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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