Individual
DR. KENT JAMES BLANKE
Active
Individual
DR. KENT JAMES BLANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
106501
MO
2086S0129X
Vascular Surgery Physician
5101010137
MI
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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