MR. Michael Wayne Blomstrom, PTA

NPI #1104944495 in Moore, Oklahoma

Provider Information

NPI Number
1104944495
Entity Type
Individual
Name
MR. Michael Wayne Blomstrom, PTA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physical Therapy Assistant
Credential
PTA
Enumeration Date
Mar 26, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
2111 RIVERWALK DR
City
Moore
ZIP Code
73160-2700
Phone
(405) 793-7885

Specialties & Taxonomy Codes

Specialty
Physical Therapy Assistant

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