Individual
DAVID BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
522 E. LAKE MEAD PARKWAY, SUITE 5, HENDERSON, NV 89015
(702) 486-6714
Mailing address
522 E LAKE MEAD PKWY STE 5, HENDERSON, NV 89015-5573
(702) 486-6714
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/12/2017
Last updated
07/21/2022
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