Provider Demographics
NPI:1346702339
Name:BLANKS, ANNEMARIE ELAINE (PT)
Entity Type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:ELAINE
Last Name:BLANKS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27511 HOLIDAY LN STE 105
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5397
Mailing Address - Country:US
Mailing Address - Phone:567-342-0687
Mailing Address - Fax:866-593-6617
Practice Address - Street 1:27511 HOLIDAY LN STE 105
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5397
Practice Address - Country:US
Practice Address - Phone:567-342-0687
Practice Address - Fax:866-593-6617
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT017913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist