Provider Demographics
NPI:1508232729
Name:BLASCOE, NIKOLAS
Entity Type:Individual
Prefix:
First Name:NIKOLAS
Middle Name:
Last Name:BLASCOE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CRESCENT CENTRE DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7269
Mailing Address - Country:US
Mailing Address - Phone:615-656-0379
Mailing Address - Fax:615-221-9054
Practice Address - Street 1:132 N BELVEDERE DR
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-5418
Practice Address - Country:US
Practice Address - Phone:615-451-1877
Practice Address - Fax:615-451-1878
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist