Individual
ALEXANDER DANIEL BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4076 NEELY RD, RM 3C-404, FT. WAINWRIGHT, AK 99703-7440
(907) 361-6028
Mailing address
4076 NEELY RD, RM 3C-404, FT. WAINWRIGHT, AK 99703
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/26/2023
Last updated
10/13/2023
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