Individual
DR. BLAKE HOWARD DEBORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
5078 WILLIAMSPORT PIKE STE 1, MARTINSBURG, WV 25404-6458
(304) 271-8895
Mailing address
54 MAGENTA LN, MARTINSBURG, WV 25405-1443
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004173
WV
Other
Enumeration date
06/05/2022
Last updated
08/16/2022
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