Provider Demographics
NPI:1104273598
Name:BLANCHETT, ALEXANDER JAMES
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JAMES
Last Name:BLANCHETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16970 CHANDLER RD
Mailing Address - Street 2:APPT. 3302
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6101
Mailing Address - Country:US
Mailing Address - Phone:734-497-1690
Mailing Address - Fax:
Practice Address - Street 1:16970 CHANDLER RD
Practice Address - Street 2:APPT. 3302
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6101
Practice Address - Country:US
Practice Address - Phone:734-497-1690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner