Individual
CORY BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
460 S MAIN ST, DAVIDSON, NC 28036-8006
(704) 255-6383
Mailing address
460 S MAIN ST # 302, DAVIDSON, NC 28036-8006
(704) 255-6383
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
P23407
NC
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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