Individual
EMILY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6400 E BROAD ST STE 400, COLUMBUS, OH 43213-1505
(614) 404-8170
Mailing address
3541 CADELL RD, COLUMBUS, OH 43232-6006
(614) 404-8170
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
367062
OH
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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