Individual
BLAKE POLLEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1337 GRAY WOLF CIR, PUEBLO, CO 81001-4932
(320) 241-2514
Mailing address
34382 COUNTY ROAD 89, BROWERVILLE, MN 56438
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000017573
ND
Other
Enumeration date
08/28/2014
Last updated
08/07/2019
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