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Individual

MICHAEL BLAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
13801 ST FRANCIS BLVD STE 200, MIDLOTHIAN, VA 23114-3206
(804) 320-4064
Mailing address
PO BOX 715868, PHILADELPHIA, PA 19171-5868
(804) 915-1910
(804) 327-9812

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2305215230
VA

Other

Enumeration date
08/09/2022
Last updated
10/10/2022
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