Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 01274 | IA |
NPI | 1003080128 |
---|---|
Provider Name | Andrew Vanblair |
First Address | Louisville, KY 40202-2407 |
Second Address | Urbandale, IA 50323-2193 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 02/01/2019 |