Individual
MS. JESSICA SMITH-BLOCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6497
OR
225100000X
Physical Therapist
PT-2230
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952508996
—
ID
05
—
1952508996-000
—
ID
05
—
500635041
—
OR
05
—
808225200
—
ID
01
—
R195724
MEDICARE
OR
Enumeration date
07/02/2007
Last updated
09/14/2017
Update your record
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