Individual
BLAKE MITCHELL CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
HS
Contact information
Practice address
451 ARCHIBALD CT, COLTON, CA 92324-2133
(909) 580-0793
Mailing address
451 ARCHIBALD CT, COLTON, CA 92324-2133
(909) 580-0793
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/28/2007
Last updated
08/28/2007
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