Individual
BLAKE WILLIAM PALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LPA
Contact information
Practice address
735 NORTH DR, HOPKINSVILLE, KY 42240-2620
(270) 886-5163
(270) 886-5178
Mailing address
PO BOX 614, HOPKINSVILLE, KY 42241-0614
(270) 886-2205
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
172433
KY
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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