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LISA BLACKSTON PTA

Individual Provider (NPI-1) Active

Physical Therapy Assistant

Provider Information

NPI Number
1346114287
Provider Type
Individual Provider (NPI-1)
Credentials
PTA
Status
Active

Contact & Location

Address
3431 N 13TH ST, SHEBOYGAN, WI, 530832938
Phone
(920) 457-5046

Specialties & Taxonomies

Physical Therapy Assistant Primary

All Addresses

MAILING

W6680 COUNTY ROAD JP

ELKHART LAKE, WI, 530201903

LOCATION

3431 N 13TH ST

SHEBOYGAN, WI, 530832938

(920) 457-5046