Individual
RICKY N BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7502 W FLORISSANT AVE, SAINT LOUIS, MO 63136-1342
(314) 296-3027
Mailing address
7502 W FLORISSANT AVE, SAINT LOUIS, MO 63136-1342
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
12/15/2023
Last updated
12/15/2023
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