Individual
CAROLYN BLASCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
161 E MALLARD DR STE 120, BOISE, ID 83706-5015
(208) 884-1333
Mailing address
3912 SAGE CREEK DR, BOISE, ID 83714-5502
(406) 521-0252
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
8471548
ID
Other
Enumeration date
06/05/2016
Last updated
01/16/2025
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