Individual
MR. BLAKE R HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
410 N TAYLOR STREET, WEAVERVILLE, CA 96093
(530) 623-4186
(530) 623-4397
Mailing address
PO BOX 1229, 410 N TAYLOR STREET, WEAVERVILLE, CA 96093
(530) 623-4186
(530) 623-4397
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA11470
CA
Other
Enumeration date
10/28/2006
Last updated
07/08/2007
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