Provider Demographics
NPI:1134745102
Name:BLUMENSCHEIN, DOUGLAS ARTHUR (PTA)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ARTHUR
Last Name:BLUMENSCHEIN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4907 W NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-3355
Mailing Address - Country:US
Mailing Address - Phone:937-605-9344
Mailing Address - Fax:
Practice Address - Street 1:404 E MCCREIGHT AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-3653
Practice Address - Country:US
Practice Address - Phone:937-399-8311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant