| Doctor Name: | KEVIN LAYNE BLANCHARD |
| NPI Number: | 1497198311 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 7986778-2401 |
| Business Practice Address: | 5957 Fashion Point Dr Ste. 102 South Ogden, UT - 844035180 |
| Business Phone Number: | 8018270200 |
| Business Fax Number: | |
| Mailing Address: | 5957 Fashion Point Dr, Ste. 102 SOUTH OGDEN |
| State: | UT |
| Postal Code: | 844035180 |
| Phone Number: | 8018270200 |
| Fax Number: | |
| NPI Enumeration Date: | 04/10/2013 |
| NPI Last Update Date: | 04/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 7986778-2401 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |