Individual
DR. CONRAD JAMES BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3515 AIRWAY DR, SUITE 210, RENO, NV 89511-1849
(775) 851-7788
(775) 851-7788
Mailing address
2801 GROSMONT DR, SPARKS, NV 89436-7047
(775) 851-7788
(775) 851-7787
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
NV16076
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NV16076
NV BOARD OF PHARMACY LIC
NV
Enumeration date
09/27/2005
Last updated
08/02/2007
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