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Individual

MR. RONALD BLAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RRT

Contact information

Practice address
702 CROMWELL DRIVE, SUITE A, GREENVILLE, NC 27858
(252) 830-2094
(252) 355-7358
Mailing address
702 CROMWELL DRIVE, SUITE A, GREENVILLE, NC 27858
(252) 830-2094
(252) 355-7358

Taxonomy

Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
A2000
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012AG
BCBS
NC
05
7492673
NC
Enumeration date
10/03/2006
Last updated
07/08/2007
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