Blakely, Gregory M

Blakely, Gregory M is an individual health care provider with primary practice located at 811 North 1St Street , Vienna IL 62995. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Blakely, Gregory M can be contacted via phone (618) 658-8144.

Contact Information

Primary practice address
811 North 1St Street Vienna IL 62995
Phone: (618) 658-8144
Fax: (618) 658-9146
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070.005246 Illinois

Profile Details

NPI number 1538663463
LBN Legal business name Blakely, Gregory M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2018
Last updated Mar 23rd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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