Individual
JEANNE MARIE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
999 TRAIL TERRACE DR, NAPLES, FL 34103-2329
(239) 649-2222
(239) 649-0522
Mailing address
6631 EASTWOOD ACRES RD, FORT MYERS, FL 33905-6111
(239) 738-6972
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA23109
FL
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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