Individual
DR. BLAKE FREDERICK ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
900 HAMMOND ST STE D, BANGOR, ME 04401-4378
(207) 973-6356
Mailing address
105A GRIFFIN RD, LEVANT, ME 04456
(805) 704-3968
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT7117
ME
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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