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Individual

MR. FREDERICO BOBLITZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-2786
Mailing address
2813 LAFAYETTE AVE, LANSING, MI 48906-2637

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502002141
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5502002141
MI
Enumeration date
12/26/2018
Last updated
12/26/2018
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