Individual
KAREN BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2606 COAST ST., BRUNSWICK, GA 31521-2606
(912) 289-7828
(912) 289-9378
Mailing address
PO BOX 2606, BRUNSWICK, GA 31521-2606
(912) 289-7828
(912) 289-9378
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
036870799
GA
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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