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1417406331
BLAKE HADDON
STROUDSBURG, PA
NPI
1417406331
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: PA 75-2575595)
Enumeration Date
2016-10-04
Last Update Date
2016-10-04
Business Address
-- BLAKE HADDON
113 LARSEN LANE
STROUDSBURG, PA 18360-0113
Phone number: 570-801-8240
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Mailing Address
-- BLAKE HADDON
PO BOX 33
STROUDSBURG, PA 18360-0033
Phone number: 570-801-8240
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