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General NPI Number Information
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NPI Number | 1770672909
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Entity Type | Organization
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Legal Business Name | BLANKINSHIP PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 12/22/2011
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Provider Practice Location Address
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Address Line | 1534 E RAY RD STE 104
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City | GILBERT
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State | AZ
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Zip | 85296-4429
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Country | US
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Telephone | 480-855-5542
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Fax | 480-855-5756
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Provider Business Mailing Address
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Address Line | 1534 E RAY RD STE 104
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City | GILBERT
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State | AZ
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Zip | 85296-4429
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Country | US
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Telephone | 480-855-5542
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Fax | 480-855-5756
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Authorized Official
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Title or Position | OWNER
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Name | MR. CRAIG A BLANKINSHIP
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Credential | MSPT
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Telephone | 480-855-5542
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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 | 4181
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License Number State | AZ
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