Individual
BLAKE GESCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2776 S STATE RD, IONIA, MI 48846-8472
(616) 775-7500
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008070
MI
Other
Enumeration date
12/30/2016
Last updated
02/20/2017
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