Individual
LISA RENEE BLENKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4929 S VAL VISTA DR, GILBERT, AZ 85298-0664
(480) 590-6921
Mailing address
4929 S VAL VISTA DR, GILBERT, AZ 85298-0664
(480) 590-6921
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
LPT-31502
AZ
2251G0304X
Geriatric Physical Therapist
PT 25362
CA
Other
Enumeration date
07/12/2007
Last updated
08/25/2021
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