Individual
TORIE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6313 BEGOLE ST, DETROIT, MI 48210-1209
(313) 229-0788
Mailing address
6313 BEGOLE ST, DETROIT, MI 48210-1209
(313) 229-0788
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
09/23/2010
Last updated
02/28/2017
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