Blakely, Jerry W
Blakely, Jerry W is an individual health care provider with primary practice located at 2200 Ironwood Pl , Coeur D Alene ID 83814-2610. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as his primary health care specialty. Blakely, Jerry W can be contacted via phone (208) 667-6486.Contact Information
Primary practice address
2200 Ironwood Pl
Coeur D Alene ID 83814-2610
Phone: (208) 667-6486
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X |
Profile Details
| NPI number | 1891992657 |
|---|---|
| LBN Legal business name | Blakely, Jerry W |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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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