Individual
EMMA BLANKENSHIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
13537 BARRETT PARKWAY DR, SUITE 105, BALLWIN, MO 63021-5899
(314) 477-8574
Mailing address
13537 BARRETT PARKWAY DR, SUITE 105, BALLWIN, MO 63021-5899
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2012023810
MO
Other
Enumeration date
12/02/2014
Last updated
12/02/2014
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