Individual
BLAKE COX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 BROOKE AVE, CINCINNATI, OH 45230-3612
(513) 575-6554
Mailing address
1115 BROOKE AVE, CINCINNATI, OH 45230-3612
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1305192
—
OH
Enumeration date
12/31/2020
Last updated
12/31/2020
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