Individual
HEIDI ANN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
234 BIRCHTREE DR, GREENWOOD, SC 29649-1502
(864) 223-0900
Mailing address
234 BIRCHTREE DR, GREENWOOD, SC 29649-1502
(864) 223-0900
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4057
SC
Other
Enumeration date
02/21/2008
Last updated
12/03/2008
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