Provider Demographics
NPI:1467935296
Name:BLANZY, ARYN RENEE
Entity Type:Individual
Prefix:
First Name:ARYN
Middle Name:RENEE
Last Name:BLANZY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 S BOND ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-2220
Mailing Address - Country:US
Mailing Address - Phone:931-434-5029
Mailing Address - Fax:
Practice Address - Street 1:128 N WARREN AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48607-1548
Practice Address - Country:US
Practice Address - Phone:989-754-8598
Practice Address - Fax:989-754-5154
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist