Individual
MICHAEL JACK BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
390 S WILCOX ST STE B, CASTLE ROCK, CO 80104-1951
(303) 839-8068
(303) 835-3597
Mailing address
390 S WILCOX ST STE B, CASTLE ROCK, CO 80104-1951
(303) 839-8068
(303) 835-3597
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20757
CO
225100000X
Physical Therapist
5501303478
MI
Other
Enumeration date
09/03/2024
Last updated
08/05/2025
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