Individual
BLAKE REVLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1508 CARL ADAMS DR UNIT 200, MURFREESBORO, TN 37129-4375
(615) 893-4896
Mailing address
2220 SPAIN HILL RD, LASCASSAS, TN 37085-5143
(615) 785-9563
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000005269
TN
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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