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Individual

MR. PAUL DAVID BLAKELEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPO FAAOP

Contact information

Practice address
102 WILLOW LANE, SPARTANBURG, SC 29307-1343
(864) 582-4411
(864) 573-6717
Mailing address
102 WILLOW LANE, SPARTANBURG, SC 29307-1343
(864) 582-4411
(864) 573-6717

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
SC
224P00000X
Prosthetist
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7701424
NC
05
DME285
SC
Enumeration date
11/13/2006
Last updated
09/11/2025
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