| NPI | 1639619216 |
|---|---|
| Doing Business As | BLAKEWELL PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | INDIA MICHEL Practice Administrator 508-232-6963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-05-03 |