Provider Demographics
NPI:1326236159
Name:BLAICH, THOMAS F (CP)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:F
Last Name:BLAICH
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:969 PACIFIC ST STE B
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4438
Mailing Address - Country:US
Mailing Address - Phone:831-649-5347
Mailing Address - Fax:831-649-1509
Practice Address - Street 1:969 PACIFIC ST STE B
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4438
Practice Address - Country:US
Practice Address - Phone:831-649-5347
Practice Address - Fax:831-649-1509
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist