Individual
BLAKE EVAN PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
252 RURAL ACRES DR, BECKLEY, WV 25801-3503
(304) 252-8555
Mailing address
252 RURAL ACRES DR, BECKLEY, WV 25801-3503
(304) 252-8555
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ED1327
WV
Other
Enumeration date
07/01/2024
Last updated
02/07/2025
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