Individual
DR. KELLY CORINNE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1340 BOYLSTON ST # 6F, BOSTON, MA 02215-4302
(857) 313-6594
(617) 236-4262
Mailing address
1340 BOYLSTON ST # 6F, BOSTON, MA 02215-4302
(857) 313-6594
(617) 236-4262
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4644
MA
Other
Enumeration date
08/18/2008
Last updated
05/16/2019
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