Evan Blazek

NPI #1164301677 in Ada, Ohio

Provider Information

NPI Number: 1164301677
Entity Type: Individual
Name: Evan Blazek
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Aug 28, 2025
Last Updated: Aug 28, 2025

Practice Location

Address: 402 W COLLEGE AVE UNIT 2622
City: Ada
State: Ohio
ZIP Code: 45810-6109
Phone: (317) 474-5402

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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