Individual
MR. ALFRED BLAKEMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3642 BOTANICAL AVE, SAINT LOUIS, MO 63110-4002
(341) 664-8616
Mailing address
3642 BOTANICAL AVE, SAINT LOUIS, MO 63110-4002
(341) 664-8616
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7147
—
MO
Enumeration date
03/13/2007
Last updated
07/09/2007
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