Individual
AUSTIN BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
18301 N 79TH AVE, GLENDALE, AZ 85308-8463
(623) 486-3333
(623) 486-3333
Mailing address
18301 N 79TH AVE, GLENDALE, AZ 85308-8463
(623) 486-3333
(623) 486-3355
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13214
AZ
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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