Individual
BLAKE HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
475 E MAIN ST, SUITE 103-105, PATCHOGUE, NY 11772-3121
(631) 289-0044
(631) 447-6126
Mailing address
475 E MAIN ST, SUITE 103-105, PATCHOGUE, NY 11772-3121
(631) 289-0044
(631) 447-6126
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
026993-1
NY
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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