Individual
BLAKE MORROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 COYOTE CIR, BLACK HAWK, CO 80422-8711
(903) 720-2574
Mailing address
515 COYOTE CIR, BLACK HAWK, CO 80422-8711
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PM.0338559
CO
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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