Individual
JEREMY THOMAS BLACKSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2500 W STRUB RD STE 150, SANDUSKY, OH 44870-5488
(419) 626-4162
(419) 626-1268
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 609-1112
(419) 609-1123
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT003168
WV
225100000X
Physical Therapist
PT006231
KY
225100000X
Physical Therapist
Primary
PT014357
OH
Other
Enumeration date
06/27/2013
Last updated
04/25/2016
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