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1336621093
JAMES BLAKE
PHILADELPHIA, PA
NPI
1336621093
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2018-08-29
Last Update Date
2018-08-29
Business Address
JAMES BLAKE
2126 N 18TH ST
PHILADELPHIA, PA 19121-1623
Phone number: 443-610-0176
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Mailing Address
JAMES BLAKE
5629 SAGRA RD
BALTIMORE, MD 21239-2825
Phone number: 443-610-0176
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