Individual
MR. JASON DAVID BLAZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., P.T.
Contact information
Practice address
264 HEIGHTS RD, DARIEN, CT 06820-4122
(203) 655-6464
(203) 655-2859
Mailing address
264 HEIGHTS RD, DARIEN, CT 06820-4122
(203) 655-6464
(203) 655-2859
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
005925
CT
Other
Enumeration date
05/10/2006
Last updated
10/17/2007
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