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General NPI Number Information
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NPI Number | 1336080589
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Entity Type | Individual
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Provider Name | JESSICA BLOSSER
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 5750 W THUNDERBIRD RD
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City | GLENDALE
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State | AZ
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Zip | 85306-4660
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Country | US
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Telephone | 480-935-0614
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Fax |
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Provider Business Mailing Address
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Address Line | 5639 W CROCUS DR
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City | GLENDALE
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State | AZ
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Zip | 85306-4229
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Country | US
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Telephone | 602-448-7106
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Fax | 602-448-7106
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA-009901
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License Number State | AZ
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