Organization
BLAKE CHIROPRACTIC & REHAB CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT O BLAKE D.C. (DOCTOR)
(717) 657-2561
Entity
Organization
Contact information
Practice address
275 S HOUCKS RD, HARRISBURG, PA 17109-2907
(717) 657-2561
(717) 657-8217
Mailing address
275 S HOUCKS RD, HARRISBURG, PA 17109-2907
(717) 657-2561
(717) 657-8217
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
PA0002487
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02520900
CAPITOL BLUE CROSS
PA
05
—
0937995
—
PA
01
—
3000116
KEYSTONE
PA
01
—
BL1840042
BLUE SHIELD
PA
Enumeration date
11/16/2006
Last updated
06/11/2012
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