Organization
DR THOMAS BLAKE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS BLAKE DC (CHIROPRACTOR)
(336) 622-1600
Entity
Organization
Contact information
Practice address
122 N FAYETTEVILLE ST, LIBERTY, NC 27298-3203
(336) 622-1600
(336) 622-1600
Mailing address
PO BOX 1185, LIBERTY, NC 27298-1185
(336) 622-1600
(336) 622-1600
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890830H
—
NC
Enumeration date
11/15/2007
Last updated
11/15/2007
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