Individual
MR. IAN DAVID BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6767 S YALE AVE, SUITE B, TULSA, OK 74136-3302
(918) 494-3000
(918) 494-0003
Mailing address
6767 S YALE AVE, SUITE B, TULSA, OK 74136-3302
(918) 494-3000
(918) 494-0003
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3742
OK
Other
Enumeration date
02/27/2006
Last updated
06/14/2010
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