Individual
BLAKE LAING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5535 S WILLIAMSON BLVD, STE 774, PORT ORANGE, FL 32128-8311
(800) 330-7711
Mailing address
5535 S WILLIAMSON BLVD, STE 774, PORT ORANGE, FL 32128-8311
(800) 330-7711
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306603132
VA
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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