Individual
KYLE BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
503 1ST ST S STE 4, YELM, WA 98597-7634
(360) 400-5625
Mailing address
38612 ALLEN RD S, ROY, WA 98580-9129
(253) 455-1479
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC60902550
WA
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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