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Individual

SAMANTHA BLIMLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
873 GROVE ST, JACKSONVILLE, IL 62650-2828
(217) 479-3400
Mailing address
751 MASSEY LN, MURRAYVILLE, IL 62668-8166
(217) 490-0467

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.005053
IL

Other

Enumeration date
11/07/2018
Last updated
11/07/2018
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