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1508594912
JONATHAN BLAISE
JOHNSON CITY, TN
NPI
1508594912
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: TN 8222)
Enumeration Date
2022-08-12
Last Update Date
2022-08-12
Business Address
JONATHAN BLAISE
400 N BOONE ST
JOHNSON CITY, TN 37604
Phone number: 423-929-2900
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Mailing Address
JONATHAN BLAISE
3004 SHELBY ST
BRISTOL, TN 37620-3478
Phone number: 518-569-9887
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