Individual
MAURA K BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Mailing address
411 WALNUT ST # 15228, GREEN COVE SPRINGS, FL 32043-3443
(201) 951-4890
(201) 907-3165
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070027460
IL
225100000X
Physical Therapist
Primary
1363068
TX
225100000X
Physical Therapist
2305211239
VA
225100000X
Physical Therapist
304618
CA
225100000X
Physical Therapist
40QA01260100
NJ
225100000X
Physical Therapist
PT031329
PA
225100000X
Physical Therapist
PT210002312
DC
Other
Enumeration date
10/09/2007
Last updated
10/05/2023
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