Doctor Name: | BLAKE EVAN BOLLWITT |
NPI Number: | 1801143094 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPT |
License Number: | 3145 |
Business Practice Address: | 2305 N St Ord, NE - 688621632 |
Business Phone Number: | 4023404167 |
Business Fax Number: | |
Mailing Address: | 280 N 8th Ave, P.o. Box 846 BURWELL |
State: | NE |
Postal Code: | 688234168 |
Phone Number: | 4023404167 |
Fax Number: | 3083465111 |
NPI Enumeration Date: | 08/07/2012 |
NPI Last Update Date: | 08/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 3145 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
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 |