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NPI Code Detail

MEDICARE: MRS. LAURA BLASCO P.T.

MEDICARE: MRS. LAURA BLASCO P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT-11086OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
234-1627933OTHEROHTRICARE
3OH4655AOTHEROHBEECH STREET CORPORATION
4000000217473OTHEROHANTHEMBLUECROSS/BLUESHIEL

General Provider Information

NPI Number : 1386745859
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LAURA BLASCO P.T.
Provider Business Mailing Address
First Line : 8732 ROYALHAVEN DR
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-1657
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5273 BROADVIEW RD
Second Line :
City : PARMA
State : OH
Zip : 44134-1626
Country : US
Telephone Number : 216-749-6650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 07/09/2008

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Directions to “ MRS. LAURA BLASCO P.T.” Practice Location

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