Individual
MRS. AMY MICHELLE BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
37770 STATE ROUTE 124, POMEROY, OH 45769-9302
(740) 992-0840
Mailing address
37770 STATE ROUTE 124, POMEROY, OH 45769-9302
(740) 992-0840
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001239
OH
Other
Enumeration date
05/05/2007
Last updated
07/08/2007
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