Individual
MR. BLAKLEY WALKER SPROLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2410 ATHERHOLT RD, LYNCHBURG, VA 24501-2148
(434) 200-1800
Mailing address
3500 S GREAT SOUTHWEST PKWY APT 307, GRAND PRAIRIE, TX 75052-7385
(276) 791-0837
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-007454
VA
363A00000X
Physician Assistant
PA17104
TX
Other
Enumeration date
09/02/2019
Last updated
12/03/2024
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