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1710504634
AUSTIN BLAKE PATRICK
BRANDON, MS
NPI
1710504634
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MS PT6892)
Enumeration Date
2020-06-26
Last Update Date
2020-06-26
Business Address
AUSTIN BLAKE PATRICK DPT
2015 HIGHPOINTE DRIVE
BRANDON, MS 39042-3169
Phone number:
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Mailing Address
AUSTIN BLAKE PATRICK DPT
8205 PRESIDENTS DR
HUMMELSTOWN, PA 17036-8621
Phone number: 717-839-2188
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