Individual
ANGELA RENEE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5461 E MAYFLOWER LN, WASILLA, AK 99654-7892
(907) 357-6688
Mailing address
5461 E MAYFLOWER LN, WASILLA, AK 99654-7892
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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