Individual
ELAINE KELLEY BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1010 E BUSCH BLVD STE 103, TAMPA, FL 33612-8502
(813) 935-7987
(813) 931-5215
Mailing address
501 FEATHER TREE DR, CLEARWATER, FL 33765-2456
(727) 442-8316
(727) 447-4857
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA12360
FL
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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