Individual
IAN WARD BLATTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1055 NORTH 500 WEST STE 122, BUILDING C, PROVO, UT 84604
(801) 429-0610
(801) 429-0629
Mailing address
1055 NORTH 500 WEST ATTN: CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6976691-2401
UT
Other
Enumeration date
06/24/2008
Last updated
11/27/2023
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