Provider Demographics
NPI:1508913344
Name:BLAZIER, GIGI
Entity Type:Individual
Prefix:MS
First Name:GIGI
Middle Name:
Last Name:BLAZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:GEORGANNE
Other - Middle Name:C
Other - Last Name:BLAZIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5022 E ALTA AVE
Mailing Address - Street 2:APT. #101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-4809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4411 E KINGS CANYON RD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-3604
Practice Address - Country:US
Practice Address - Phone:559-453-6616
Practice Address - Fax:559-453-4814
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner