Individual
VINCENT BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5796 YORKSHIRE RD, DETROIT, MI 48224-2039
(313) 600-8645
Mailing address
5796 YORKSHIRE RD, DETROIT, MI 48224-2039
(313) 600-8645
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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