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1487040002
JOHNATHON BLAKE
KANSAS CITY, MO
NPI
1487040002
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: MO 2019034662)
Enumeration Date
2015-04-09
Last Update Date
2023-08-17
Business Address
Dr. JOHNATHON BLAKE M.D., M.H.S.A.
2340 E MEYER BLVD STE 346
KANSAS CITY, MO 64132-1129
Phone number: 816-444-1777
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Mailing Address
Dr. JOHNATHON BLAKE M.D., M.H.S.A.
2340 E MEYER BLVD STE 346
KANSAS CITY, MO 64132-1129
Phone number: 816-444-1777
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