Individual
ALEC BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
560 SW MCFARLANE AVE, LAKE CITY, FL 32025-5614
(386) 758-4777
Mailing address
1036 SW LOGAN GLN APT 203, LAKE CITY, FL 32025-5666
(786) 879-1552
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2888
FL
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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