BLAKE MALCOLM ELY

YPSILANTI, MI
NPI1013629492
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601012493)
Enumeration Date2022-12-19
Last Update Date2024-06-19
Business Address
BLAKE MALCOLM ELY PA-C
5301 MCAULEY DR
YPSILANTI, MI 48197-1051
Phone number: 248-697-1548
Mailing Address
BLAKE MALCOLM ELY PA-C
42868 BROOKSTONE DR
NOVI, MI 48377-2713
Phone number: 248-697-1548
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