Provider Demographics
NPI:1245884329
Name:BLASI, JANET
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:BLASI
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 1:11607 W CARR CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-4201
Mailing Address - Country:US
Mailing Address - Phone:316-558-0699
Mailing Address - Fax:
Practice Address - Street 1:19931 W KELLOGG DR UNIT A
Practice Address - Street 2:
Practice Address - City:GODDARD
Practice Address - State:KS
Practice Address - Zip Code:67052-8864
Practice Address - Country:US
Practice Address - Phone:316-550-6132
Practice Address - Fax:316-550-6215
Is Sole Proprietor?:No
Enumeration Date:2019-07-28
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist