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Individual

VINCENT BLANKENSHIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT, ATC

Contact information

Practice address
ONE RODGERS DR., MILLAN PUSKAR STADIUM, MORGANTOWN, WV 26507-0877
(304) 293-9542
Mailing address
PO BOX 877 ONE RODGERS DR., MILLAN PUSKAR STADIUM, MORGANTOWN, WV 26507-0877
(304) 293-9542

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
28536
FL
225100000X
Physical Therapist
Primary
PT 003354
WV
2255A2300X
Athletic Trainer
AT001360
WV
2255A2300X
Athletic Trainer
AT001666
GA

Other

Enumeration date
05/22/2015
Last updated
05/22/2015
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