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Individual

DAVID BLAISDELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPO, LPO

Contact information

Practice address
949 STEVENS DR, RICHLAND, WA 99352-3508
(509) 946-2520
(509) 946-2530
Mailing address
949 STEVENS DR, RICHLAND, WA 99352-3508
(509) 946-2520
(509) 946-2520

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
OI00000469
WA
335E00000X
Prosthetic/Orthotic Supplier
Primary
PS00000468
WA

Other

Enumeration date
03/24/2014
Last updated
03/24/2014
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