Individual
MR. MATTHEW JOHN BLIMLINE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
929 LAKESHORE DR, LEESPORT, PA 19533-8631
(610) 916-5463
Mailing address
112 READING AVE, SHILLINGTON, PA 19607-1927
(610) 916-5463
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/17/2006
Last updated
07/08/2007
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