Individual
BLAKE ANDONIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13201 GRANGER RD, GARFIELD HEIGHTS, OH 44125-1978
(216) 831-2255
Mailing address
13201 GRANGER RD, CLEVELAND, OH 44125-1978
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2871101
—
OH
Enumeration date
11/28/2021
Last updated
08/19/2024
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