Individual
KAYLIE MARIE BLACKLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2301 EASTERN AVE, RED OAK, IA 51566-1300
(712) 623-7213
Mailing address
15646 300TH ST, TREYNOR, IA 51575-7601
(402) 680-0007
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
108976
IA
Other
Enumeration date
08/25/2021
Last updated
08/25/2021
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