Individual
CHAD ALAN BLOMQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
6860 SAINT EDMUNDS LOOP, FORT MYERS, FL 33966-7503
(309) 948-3213
Mailing address
1114 17TH AVE, MOLINE, IL 61265-3868
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
005795
IA
225700000X
Massage Therapist
227.010795
IL
225700000X
Massage Therapist
Primary
MA102775
FL
Other
Enumeration date
06/22/2010
Last updated
11/19/2024
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