Tyler J Blome, DPT
Student in an Organized Health Care Education/Training Program in Saint Peters, MO. Individual provider (NPI-1).
NPI number1033650197
StatusActive
Last updated in NPPESMar 9, 2017
Details
- NPI
- 1033650197
- Entity type
- Individual (NPI-1)
- Name
- Tyler J Blome
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 9, 2017
- Last updated
- Mar 9, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
221 Spencer RdSte D
Saint Peters, MO 63376-2438
Phone 636-477-9911 · Fax 636-477-9929
Mailing address
625 Enterprise DrOak Brook, IL 60523-8813
Phone 630-575-6200
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