Individual
BLAINE N WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LO CO LPA
Contact information
Practice address
3737 N LOY LAKE RD, SHERMAN, TX 75090-2529
(903) 983-5696
Mailing address
3737 N LOY LAKE RD, SHERMAN, TX 75090-2529
(903) 983-5696
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
180
TX
222Z00000X
Orthotist
Primary
28
OK
225000000X
Orthotic Fitter
1148
TX
225000000X
Orthotic Fitter
9
OK
Other
Enumeration date
09/01/2009
Last updated
09/01/2009
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