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1285077297
ZACHARY BLAKE
CHICAGO, IL
NPI
1285077297
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IL 160.006030)
Enumeration Date
2013-04-09
Last Update Date
2013-04-09
Business Address
-- ZACHARY BLAKE
5333 N SHERIDAN RD
CHICAGO, IL 60640-7371
Phone number: 419-357-2055
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Mailing Address
-- ZACHARY BLAKE
5333 N SHERIDAN RD
CHICAGO, IL 60640-7371
Phone number:
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