MR. Gregory M Blakely

NPI #1538663463 in Vienna, Illinois

Provider Information

NPI Number: 1538663463
Entity Type: Individual
Name: MR. Gregory M Blakely
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Mar 23, 2018
Last Updated: Mar 23, 2018

Practice Location

Address: 811 NORTH 1ST STREET
City: Vienna
State: Illinois
ZIP Code: 62995
Phone: (618) 658-8144

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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