Individual
DR. JOSHUA RYNE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4210 N ROAN ST, JOHNSON CITY, TN 37601-1130
(423) 262-0201
(423) 262-0380
Mailing address
4210 N ROAN ST, JOHNSON CITY, TN 37601
(423) 262-0201
(423) 262-0380
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36733
TN
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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