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1750390803
DANIEL STEPHEN BLAKE
MESA, AZ
NPI
1750390803
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: AZ F01309)
Enumeration Date
2006-08-07
Last Update Date
2019-09-16
Business Address
DANIEL STEPHEN BLAKE Surgical First Asst
1839 E ENROSE ST
MESA, AZ 85203-5822
Phone number: 480-220-8496
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Mailing Address
DANIEL STEPHEN BLAKE Surgical First Asst
1839 E ENROSE ST
MESA, AZ 85203-5822
Phone number: 480-220-8496
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