Mark G. Blasbalg Od INC

NPI #1902963457 in Coventry, Rhode Island

Provider Information

NPI Number: 1902963457
Entity Type: Organization
Organization Name: Mark G. Blasbalg Od INC
Primary Specialty: Optometrist
Enumeration Date: Jan 3, 2007
Last Updated: Mar 9, 2010

Practice Location

Address: 1193 TIOGUE AVE
City: Coventry
State: Rhode Island
ZIP Code: 02816-6122
Phone: (401) 823-8200

Authorized Official

Name: DR. MARK G BLASBALG, O.D.
Title: OWNER PRESIDENT
Phone: (401) 823-8200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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