Individual
BLAKE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2300 53RD AVE STE LL02, BETTENDORF, IA 52722-7565
(563) 449-7000
Mailing address
3364 E KIMBERLY RD APT 246, DAVENPORT, IA 52807-2534
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/05/2019
Last updated
06/05/2019
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