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1043948060
MICHAEL BLAKE
MIDLOTHIAN, VA
NPI
1043948060
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2251X0800X Physical Therapist, Orthopedic
(Licence: VA 2305215230)
Enumeration Date
2022-08-09
Last Update Date
2022-10-10
Business Address
MICHAEL BLAKE DPT
13801 ST FRANCIS BLVD STE 200
MIDLOTHIAN, VA 23114-3206
Phone number: 804-320-4064
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Mailing Address
MICHAEL BLAKE DPT
PO BOX 715868
PHILADELPHIA, PA 19171-5868
Phone number: 804-915-1910
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