Individual
DANIEL BLIESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
929 JUPITER ST, WEST COLUMBIA, SC 29169-3534
(617) 899-6798
Mailing address
929 JUPITER ST, WEST COLUMBIA, SC 29169-3534
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
2099
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011
PHYSICAL THERAPY
—
Enumeration date
08/08/2014
Last updated
08/08/2014
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