Jerry W Blakely II, PT
NPI #1891992657 in Coeur D Alene, Idaho
Provider Information
- NPI Number
- 1891992657
- Entity Type
- Individual
- Name
- Jerry W Blakely II, PT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapist - Orthopedic
- Credential
- PT
- Enumeration Date
- Jun 27, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 2200 IRONWOOD PL
- City
- Coeur D Alene
- State
- Idaho
- ZIP Code
- 83814-2610
- Phone
- (208) 667-6486
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist - Orthopedic — Orthopedic |
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