Individual
MR. BLAKE ALEXANDER MCKOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3891 SULLIVAN ST, MADISON, AL 35758-1740
(256) 772-9243
Mailing address
1922 W BROWNSTONE CT SW, DECATUR, AL 35603-2030
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2560
AL
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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