Individual
DR. SIMONE P. BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
6850 PERIMETER DR, SUITE A, DUBLIN, OH 43016-8051
(614) 789-5559
(614) 789-5758
Mailing address
6850 PERIMETER DR, SUITE A, DUBLIN, OH 43016-8051
(614) 789-5559
(614) 789-5758
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5288
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2333139
—
OH
Enumeration date
11/08/2005
Last updated
02/28/2008
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