Individual
EDGARDO BLANCO MATEO II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
447 PLUMTREE RD, SPRINGFIELD, MA 01118-1627
(413) 316-3308
Mailing address
447 PLUMTREE RD BSMT, SPRINGFIELD, MA 01118-1627
(413) 316-3308
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12461
CT
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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