JACOB BLASINGAME

CHAMPAIGN, IL
NPI1720619232
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085007530)
Enumeration Date2020-02-03
Last Update Date2020-02-03
Business Address
JACOB BLASINGAME PA-C
2300 S 1ST ST
CHAMPAIGN, IL 61820-7661
Phone number: 217-383-9400
Mailing Address
JACOB BLASINGAME PA-C
108 BURWASH AVE APT B
SAVOY, IL 61874-8700
Phone number:
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