Individual
BLAINE ALAN SCHOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
400 S STATION RD, GLEN CARBON, IL 62034-2743
(618) 288-5014
Mailing address
400 S STATION RD, GLEN CARBON, IL 62034-2743
(618) 288-5014
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.008256
IL
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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