Michael Wayne Blomstrom, PTA

Physical Therapy Assistant · Moore, OK

Individual Active NPI

NPI number 1104944495

Practice location

2111 Riverwalk Dr
Moore, OK 73160-2700
Phone
(405) 793-7885

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NPI record

NPI
1104944495
Entity type
Individual (Type 1)
Enumeration date
March 26, 2007
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X TA691 OK

Mailing address

2392 County Street 2940
Blanchard, OK 73010-3624
Phone
(405) 224-6639

About Michael Blomstrom

Michael Wayne Blomstrom, PTA is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 2111 Riverwalk Dr, Moore, OK 73160-2700. The NPI number 1104944495 was assigned on March 26, 2007 and the record was last updated on July 8, 2007.

Michael Blomstrom lists a license in the registry: #TA691 (OK) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Michael Wayne Blomstrom, PTA?

The NPI number is 1104944495.

What is the phone number of Michael Blomstrom?

The phone number listed for the practice location is (405) 793-7885.

Where is Michael Blomstrom located?

2111 Riverwalk Dr, Moore, OK 73160-2700.

What is the taxonomy code for Michael Blomstrom?

The primary taxonomy code is 225200000X – Physical Therapy Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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