MATTHEW ALEXANDER BLAKE

SAN DIEGO, CA
NPI1699278952
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2018-03-13
Last Update Date2018-03-13
Business Address
Mr. MATTHEW ALEXANDER BLAKE IDC
1336 BRUNNER ST APT H
SAN DIEGO, CA 92110-1690
Phone number: 931-865-6165
Mailing Address
Mr. MATTHEW ALEXANDER BLAKE IDC
1336 BRUNNER ST APT H
SAN DIEGO, CA 92110-1690
Phone number: 931-865-6165
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