Individual
MRS. SHAUNA M BLANQUIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4539 HARBOR LN, ROHNERT PARK, CA 94928-1863
(707) 695-7484
Mailing address
4539 HARBOR LN, ROHNERT PARK, CA 94928-1863
(707) 695-7484
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
030502162
CA
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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