Doctor Name: | MR. TIMOTHY PAUL BLECKE |
NPI Number: | 1053453944 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 8566 |
Business Practice Address: | 325 N Saint Paul St Suite 4200 Dallas, TX - 752013801 |
Business Phone Number: | 8669530011 |
Business Fax Number: | |
Mailing Address: | 620 E Manzanita Pl, PHOENIX |
State: | AZ |
Postal Code: | 850203667 |
Phone Number: | 6023695256 |
Fax Number: | |
NPI Enumeration Date: | 02/13/2007 |
NPI Last Update Date: | 10/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 8566 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |