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1730794348
CRYSTAL LYNN BLAKE
MOUNDSVILLE, WV
NPI
1730794348
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-09-10
Last Update Date
2020-10-21
Business Address
CRYSTAL LYNN BLAKE
87 SWIERKOS DR
MOUNDSVILLE, WV 26041-4209
Phone number: 304-843-2306
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Mailing Address
CRYSTAL LYNN BLAKE
306 W MAIN ST
PADEN CITY, WV 26159-1430
Phone number:
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