Individual
KIMBERLY BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8107 PETTIBONE RD, CHAGRIN FALLS, OH 44023-5001
(216) 339-3011
Mailing address
4443 RABUN LN, RICHMOND HEIGHTS, OH 44143-2633
(216) 339-3011
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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