Individual
MR. BLAKE LEE GUIRGUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1517 W GARVEY AVE N, WEST COVINA, CA 91790-2138
(626) 962-6061
Mailing address
1517 W GARVEY AVE N, WEST COVINA, CA 91790-2138
(626) 962-6061
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/06/2011
Last updated
06/09/2011
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