Individual
BLAKE ARTHUR PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12220 BIRMINGHAM HWY BLDG 10, STE C, MILTON, GA 30004
(770) 686-3700
Mailing address
12220 BIRMINGHAM HWY BLDG 10, STE C, MILTON, GA 30004
(770) 686-3700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT9191
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP7336
MEDICARE GROUP #
GA
Enumeration date
09/12/2007
Last updated
03/17/2018
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