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Individual

ERIK BLAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
875 PERIMETER DR, MOSCOW, ID 83844-9803
(208) 885-7447
(208) 885-9209
Mailing address
1005 PONDEROSA WAY, MOSCOW, ID 83843
(208) 310-6154

Taxonomy

Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
06/11/2025
Last updated
06/11/2025
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