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General NPI Number Information
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NPI Number | 1679324115
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Entity Type | Individual
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Provider Name | SPENCER BLANKENSHIP OTD
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Gender | Female
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 300 E HOSPITAL RD
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City | FORT EISENHOWER
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State | GA
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Zip | 30905
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Country | US
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Telephone | 706-787-5811
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Fax |
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Provider Business Mailing Address
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Address Line | 10521 BELLE POINTE DR
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City | ALEXANDRIA
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State | KY
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Zip | 41001-9196
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Country | US
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Telephone | 513-702-0745
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT012428
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License Number State | OH
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