Individual
CYNTHEA I BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PH.D.
Contact information
Practice address
3010 N. CIRCLE DRIVE SUITE 120, COLORADO SPRINGS, CO 80209
(719) 264-1500
(719) 234-0024
Mailing address
2508 E. 11TH AVENUE #301, DENVER, CO 80206-3234
(303) 394-4344
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
30244
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01302447
—
CO
Enumeration date
10/03/2006
Last updated
07/08/2007
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