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Individual

BLAKE MICHAEL MARLIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
3950 17TH ST STE B, BAKER CITY, OR 97814-1300
(541) 523-8888
(541) 523-8889
Mailing address
3950 17TH ST STE B, BAKER CITY, OR 97814-1300
(541) 523-8888
(541) 523-8889

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4182
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
228760
OR
01
P00245147
RAILROAD MEDICARE
OR
Enumeration date
07/12/2006
Last updated
10/25/2007
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