Individual
BLAKE VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4000 BLUE RIDGE RD, RALEIGH, NC 27612-4650
(919) 521-2408
Mailing address
4000 BLUE RIDGE RD, RALEIGH, NC 27612-4650
(919) 521-2408
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5332
NC
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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