TIFFANY BLASA

SALEM, IL
NPI1538347810
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy172V00000X Community Health Worker
(Licence: IL  070013674)
Enumeration Date2008-02-08
Last Update Date2008-02-08
Business Address
Mrs. TIFFANY BLASA PT
1201 RICKER RD
SALEM, IL 62881-4263
Phone number: 618-548-3194
Mailing Address
Mrs. TIFFANY BLASA PT
16870 NORTH HARMONY LANE
MT VERNON, IL 62864
Phone number: 618-978-8456