Individual
DR. SUSAN F BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2216 LINCOLN WAY E, MASSILLON, OH 44646-7062
(330) 832-9966
(330) 832-6007
Mailing address
313 LINWOOD AVE NW, CANTON, OH 44708-5624
(330) 455-2348
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5196
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202699359
VSP
OH
01
—
22683
NVA
OH
05
—
2601081
—
OH
01
—
27426
SPECTERA
OH
01
—
311529091
UNITED HEALTH CARE
OH
01
—
51108
DAVIS VISION
OH
01
—
OH00213
VBA
OH
01
—
OH5196
EYEMED
OH
Enumeration date
02/28/2006
Last updated
08/02/2011
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