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1437850674
ZACHARY ELLIS BLAKE
JEFFERSON, LA
NPI
1437850674
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: LA 338274)
Additional Taxonomies
363A00000X Physician Assistant
Enumeration Date
2023-03-14
Last Update Date
2023-09-15
Business Address
ZACHARY ELLIS BLAKE PA-C
1514 JEFFERSON HWY
JEFFERSON, LA 70121-2429
Phone number: 504-842-3000
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Mailing Address
ZACHARY ELLIS BLAKE PA-C
1514 JEFFERSON HWY
JEFFERSON, LA 70121-2429
Phone number: 504-842-4000
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