BLAKE WOLLAM

MENTOR, OH
NPI1013643048
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: OH  APRN.CNP.0031396)
Enumeration Date2022-08-01
Last Update Date2022-08-01
Business Address
BLAKE WOLLAM
7060 WAYSIDE DR
MENTOR, OH 44060-6527
Phone number: 440-357-2770
Mailing Address
BLAKE WOLLAM
2157 LAKELAND AVE
LAKEWOOD, OH 44107-5715
Phone number: 740-457-6815
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