Individual
ALLI BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9346 OAK AVE, WACONIA, MN 55387-9422
(952) 223-2506
Mailing address
3132 SE MAGNOLIA DR, ANKENY, IA 50021-9586
(605) 759-3947
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
092510
IA
Other
Enumeration date
07/05/2018
Last updated
04/16/2024
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