Individual
MRS. TRACEY POWELL BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RCP
Contact information
Practice address
23916 ELM ROAD, NORTH OLMSTED, OH 44070
(440) 979-9665
Mailing address
23916 ELM RD, NORTH OLMSTED, OH 44070-3730
(440) 979-9665
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
108584
OH
Other
Enumeration date
12/18/2009
Last updated
12/18/2009
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