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Individual

BLAKE GOLDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
51385 SW OLD PORTLAND RD STE E, SCAPPOOSE, OR 97056-4062
(503) 543-7768
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
(866) 370-8206

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
65565
OR
225100000X
Physical Therapist
NV

Other

Enumeration date
04/05/2024
Last updated
12/18/2024
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