Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SAMANTHA BLAZEK, LAT, ATC
Active Sole ProprietorSAMANTHA BLAZEK, LAT, ATC is a Athletic Trainer healthcare provider located in MALTA, Illinois. NPI 1306699608 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · MALTA, IL
Registration Details
- NPI Number
- 1306699608
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 8, 2024 (2.3146761969141 yrs)
- Last Updated
- Apr 8, 2024
- License
-
096005691 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
PO BOX 141MALTA, IL, 601500141Browse IL providers · Browse ZIP 60150
- Phone
- 8155012900
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.