Individual
MICHAEL DONTAE BLAKEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1015 W 39TH 1/2 ST, AUSTIN, TX 78756-4005
(512) 377-9042
Mailing address
1015 W 39TH 1/2 ST, AUSTIN, TX 78756-4005
(512) 377-9042
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
16263
TX
Other
Enumeration date
04/01/2025
Last updated
04/01/2025
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