BLAKE MICHAEL BODENDORFER

COUNCIL BLUFFS, IA
NPI1083000905
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207XX0005X Orthopaedic Surgery Sports Medicine
(Licence: IL  036152051)
Enumeration Date2015-04-07
Last Update Date2021-08-02
Business Address
BLAKE MICHAEL BODENDORFER M.D.
1 EDMUNDSON PL STE 500
COUNCIL BLUFFS, IA 51503-4619
Phone number: 712-323-5333
Mailing Address
BLAKE MICHAEL BODENDORFER M.D.
1611 W HARRISON ST STE 400
CHICAGO, IL 60612-4861
Phone number: 312-432-2351
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