Individual
C BLAKE AASGAARD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
1597 LANCASTER DR, MARIETTA, GA 30066-5915
(770) 218-9195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
02963
GA
Other
Enumeration date
11/30/2005
Last updated
07/08/2007
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