Individual
MR. BLAKE MARCUS HESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
12801 N 65TH AVE, GLENDALE, AZ 85304-1648
(602) 677-7958
Mailing address
12801 N 65TH AVE, GLENDALE, AZ 85304-1648
(602) 677-7958
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
06-173
CO
Other
Enumeration date
08/30/2006
Last updated
06/12/2023
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