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Individual

MATTHEW BLAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
804 S BROADWAY ST STE 1, GEORGETOWN, KY 40324-2304
(502) 642-4800
(513) 332-9072
Mailing address
600 6TH AVE, HUNTINGTON, WV 25701-2104
(304) 521-4365
(513) 332-9072

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
243740
KY

Other

Enumeration date
10/21/2019
Last updated
10/21/2019
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