Individual
DR. THOMAS LEON BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
104 NORTH GREENSBORO STREET, LIBERTY, NC 27298-3203
(336) 622-1600
Mailing address
3199 CARRIAGE CREEK CT, HAW RIVER, NC 27258-9047
(336) 261-3113
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2074
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890830H
—
NC
Enumeration date
12/05/2006
Last updated
08/24/2007
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