BLAKE BLOOMFIELD

CHARLOTTE, NC
NPI1063095743
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant Medical
Additional Taxonomies106S00000X Behavior Technician
Enumeration Date2021-04-30
Last Update Date2025-06-13
Business Address
BLAKE BLOOMFIELD PA-C
1000 BLYTHE BLVD
CHARLOTTE, NC 28203-5812
Phone number: 704-446-5185
Mailing Address
BLAKE BLOOMFIELD PA-C
145 NEW BERN ST APT 143
CHARLOTTE, NC 28209-4301
Phone number: 810-962-3192
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