Individual
KEITH ALLEN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1 VETERANS WAY, KNOXVILLE, TN 37931-3161
(865) 862-8100
Mailing address
1830 BUFFALO RD, ONEIDA, TN 37841-7403
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6125
TN
Other
Enumeration date
01/25/2019
Last updated
01/25/2019
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