Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 05011526A | IN |
NPI | 1003229360 |
---|---|
Provider Name | Courtney Bless |
First Address | Columbus, IN 47203-3239 |
Second Address | Columbus, IN 47203-3239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2014 |
Last Update Date | 23/08/2019 |