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1154894434
MICHAEL BLAKE
FARGO, ND
NPI
1154894434
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: ND 1187)
Enumeration Date
2019-01-09
Last Update Date
2020-05-12
Business Address
MICHAEL BLAKE MS, RD, LRD
2400 32ND AVE S
FARGO, ND 58103-5800
Phone number: 701-234-2245
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Mailing Address
MICHAEL BLAKE MS, RD, LRD
PO BOX 5074
SIOUX FALLS, SD 57117-5074
Phone number:
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