Individual
DR. WILTON E. BLAKE I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.MIN/BCC
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 262-3394
(937) 267-5351
Mailing address
695 GLENSPRINGS DR, SPRINGDALE, OH 45246-2129
(513) 638-8511
(513) 851-8191
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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