Individual
MICHAEL D BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2617 PARKER ST, OMAHA, NE 68111-4429
(402) 594-7156
Mailing address
10909 COTTONWOOD LN, OMAHA, NE 68164-3860
(402) 964-2848
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
02/13/2025
Last updated
02/13/2025
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