Individual
ALEX BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
10743 S STATE ROUTE 133, BLANCHESTER, OH 45107-9435
(937) 728-9782
Mailing address
7777 YANKEE RD, LIBERTY TOWNSHIP, OH 45044-3500
(513) 803-9600
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
157559
OH
Other
Enumeration date
03/17/2016
Last updated
03/17/2016
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