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1750432985
SALLY S BLAKE
ORANGEBURG, SC
NPI
1750432985
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: SC 710)
Enumeration Date
2007-01-15
Last Update Date
2019-02-11
Business Address
SALLY S BLAKE FNP-C
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118
Phone number: 803-536-1571
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Mailing Address
SALLY S BLAKE FNP-C
2319 SAINT MATTHEWS RD
ORANGEBURG, SC 29118-2042
Phone number: 803-536-1571
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