SearchIllinois2255A2300X

Samantha Blazek, LAT, ATC

NPI 1306699608 · on the registry since 2024 · sole proprietor

Practice

Address
Po Box 141
Malta, IL 60150
Phone
(815) 501-2900

Registry record

Primary taxonomy
2255A2300X
2255A2300X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-04-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois