Individual
BLAKE MIGLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS, CSCS
Contact information
Practice address
4364 HERITAGE TRACE PKWY STE 108, FORT WORTH, TX 76244-9125
(817) 379-1400
(817) 379-1404
Mailing address
PO BOX 2650, COPPELL, TX 75019-8607
(972) 724-2400
(972) 724-2495
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1308356
TX
Other
Enumeration date
08/09/2018
Last updated
08/29/2022
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