Individual
MARC B BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2102 MACARTHUR DR STE C, ALEXANDRIA, LA 71301-3763
(866) 550-6849
Mailing address
5750 JOHNSTON ST STE 502, LAFAYETTE, LA 70503-5334
(337) 417-9200
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007076923
DRIVERS LICENSE
LA
Enumeration date
11/19/2021
Last updated
11/19/2021
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