Individual provider · Type 1 NPI

Michael Wayne Blomstrom, PTA

Physical Therapy Assistant · Moore, OK

NPI number 1104944495 Active

Practice location

2111 Riverwalk Dr
Moore, OK 73160-2700

Call (405) 793-7885 Map

Mailing address

2392 County Street 2940
Blanchard, OK 73010-3624

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000XTA691 (OK)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1104944495

Michael Wayne Blomstrom, PTA's National Provider Identifier is 1104944495, issued on Mar 26, 2007. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Moore, OK. The record was last updated on Jul 8, 2007.