Healthcare Provider Details

I. General information

NPI: 1952314015
Provider Name (Legal Business Name): VALERIE BLASINGAME D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N MILL ST
COLDWATER OH
45828-1219
US

IV. Provider business mailing address

201 N MILL ST
COLDWATER OH
45828-1219
US

V. Phone/Fax

Practice location:
  • Phone: 419-678-7746
  • Fax: 419-678-1327
Mailing address:
  • Phone: 419-678-7746
  • Fax: 419-678-1327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2441
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: