Provider Demographics
NPI:1841906203
Name:BLASKEY, BENNETT MARK (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:BENNETT
Middle Name:MARK
Last Name:BLASKEY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:10613 N UNION CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:DE
Mailing Address - Zip Code:19960-3518
Mailing Address - Country:US
Mailing Address - Phone:302-424-3266
Mailing Address - Fax:
Practice Address - Street 1:701 SAVANNAH RD STE A1
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1550
Practice Address - Country:US
Practice Address - Phone:302-644-2530
Practice Address - Fax:302-644-2556
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0000153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist