Individual
JOHN BLAKELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
515 BROAD ST, PERRYVILLE, MD 21903-2678
(410) 642-2411
Mailing address
515 BROAD ST, PERRYVILLE, MD 21902-0000
(410) 642-2411
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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