Provider Demographics
NPI:1467595066
Name:BLOINK, JANICE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:MARIE
Last Name:BLOINK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42164-1275
Mailing Address - Country:US
Mailing Address - Phone:270-237-5070
Mailing Address - Fax:270-237-5020
Practice Address - Street 1:200 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42164-1275
Practice Address - Country:US
Practice Address - Phone:270-237-5070
Practice Address - Fax:270-237-5020
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3770111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYT54489Medicare UPIN
KY6091002Medicare ID - Type Unspecified