Individual
MRS. GRETCHEN M BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1801 RESEARCH BLVD STE 103, ROCKVILLE, MD 20850-3172
(301) 978-7730
(301) 978-7731
Mailing address
1801 RESEARCH BLVD STE 103, ROCKVILLE, MD 20850-3172
(301) 978-7730
(301) 978-7731
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2654
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22606
PHYSICAL THERAPY LICENSE - STATE OF MARYLAND
MD
01
—
DTP-2654
DPT LICENSE
HI
Enumeration date
02/27/2007
Last updated
11/17/2022
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