BEVAN D BLAKE

SALT LAKE CITY, UT
NPI1114928868
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: UT  344859-2401)
Enumeration Date2005-08-03
Last Update Date2012-10-10
Business Address
-- BEVAN D BLAKE PT, DPT
370 E SOUTH TEMPLE #250
SALT LAKE CITY, UT 84111-1206
Phone number: 801-512-2656
Mailing Address
-- BEVAN D BLAKE PT, DPT
370 E SOUTH TEMPLE #250
SALT LAKE CITY, UT 84111-1206
Phone number: 801-512-2656
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