Individual
DR. LINDA A BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
55185 SHELBY RD, SHELBY TOWNSHIP, MI 48316-1150
(248) 650-5200
(248) 651-1948
Mailing address
1606 STANLEY AVE, PONTIAC, MI 48340-1025
(248) 745-6731
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
LB007856
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123532
PREFERRED CHOICES
MI
05
—
4967188
—
MI
01
—
5260086
AETNA
MI
01
—
CH630035
M-CARE
MI
Enumeration date
05/11/2006
Last updated
07/08/2007
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