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1407834781
JEFFREY LEE BLAKE
SANTA MONICA, CA
NPI
1407834781
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA PT17676)
Enumeration Date
2006-01-06
Last Update Date
2011-11-09
Business Address
Mr. JEFFREY LEE BLAKE PT
1714 17TH ST
SANTA MONICA, CA 90404-4410
Phone number: 310-392-7889
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Mailing Address
Mr. JEFFREY LEE BLAKE PT
1714 17TH ST
SANTA MONICA, CA 90404-4410
Phone number: 310-392-7889
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