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General NPI Number Information
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NPI Number | 1093436651
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Entity Type | Individual
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Provider Name | KELLY BLOCHLINGER PT
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Gender | Female
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 09/12/2022
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Provider Practice Location Address
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Address Line | 1910 WASHINGTON VALLEY RD
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City | MARTINSVILLE
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State | NJ
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Zip | 08836-2026
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Country | US
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Telephone | 201-401-0702
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Fax |
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Provider Business Mailing Address
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Address Line | 159 BELVIDERE AVE
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City | FANWOOD
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State | NJ
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Zip | 07023-1601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01939600
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License Number State | NJ
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