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Individual

DR. JOHNATHON BLAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., M.H.S.A.

Contact information

Practice address
2340 E MEYER BLVD STE 346, KANSAS CITY, MO 64132-1129
(816) 444-1777
(813) 333-3277
Mailing address
2340 E MEYER BLVD STE 346, KANSAS CITY, MO 64132-1129
(816) 444-1777

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
04-42530
KS
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2019034662
MO

Other

Enumeration date
04/09/2015
Last updated
04/08/2026
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