Individual
MR. CHARLES R BLAKE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
103 N MAIN ST, PEEBLES, OH 45660-1246
(937) 587-3100
Mailing address
456 FAIR PARK AVE, WEST UNION, OH 45693-1057
(937) 544-2037
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03-2-06698
OH
Other
Enumeration date
11/25/2005
Last updated
07/08/2007
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