MICHAEL WAYNE BLOMSTROM

MOORE, OK
NPI1104944495
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: OK  TA691)
Enumeration Date2007-03-26
Last Update Date2007-07-08
Business Address
Mr. MICHAEL WAYNE BLOMSTROM PTA
2111 RIVERWALK DR
MOORE, OK 73160-2700
Phone number: 405-793-7885
Mailing Address
Mr. MICHAEL WAYNE BLOMSTROM PTA
2392 COUNTY STREET 2940
BLANCHARD, OK 73010-3624
Phone number: 405-224-6639
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