Individual
SCOTT PATRICK BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1711 N 6TH 1/2 ST STE 100, TERRE HAUTE, IN 47804-2700
(859) 257-7616
Mailing address
280 MORSE LANDING DR, CICERO, IN 46034-9519
(317) 379-3893
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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