Individual
BLAKE LAIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3 SAINT ELIZABETH BLVD STE 4000, O FALLON, IL 62269-1284
(618) 233-5480
Mailing address
3 SAINT ELIZABETH BLVD STE 4000, O FALLON, IL 62269-1284
(618) 233-5480
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
03/19/2024
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