Individual
RACHELLE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8736 JOHN JOHN CT, POWELL, OH 43065-9228
(614) 519-2519
Mailing address
8736 JOHN JOHN CT, POWELL, OH 43065-9228
(614) 519-2519
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
RN427075
OH
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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