Individual
BLAKE EVAN BOLLWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2305 N ST, ORD, NE 68862-1632
(402) 340-4167
Mailing address
280 N 8TH AVE, P.O. BOX 846, BURWELL, NE 68823-4168
(402) 340-4167
(308) 346-5111
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3145
NE
Other
Enumeration date
08/07/2012
Last updated
08/13/2012
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