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General NPI Number Information
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NPI Number | 1356504310
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Entity Type | Individual
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Provider Name | BLESSEN SAMUEL PT
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Gender | Male
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 439 S MAIN ST SUITE NO 160
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City | ROCHESTER
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State | MI
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Zip | 48307-2106
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Country | US
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Telephone | 713-391-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 31 E JUDITH ANN DR
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-2106
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Country | US
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Telephone | 713-391-7000
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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 | 5501013748
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License Number State | MI
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