Individual
BLAKE A. DICKENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
85 N MEDICAL DR, SALT LAKE CITY, UT 84112-1100
(801) 581-2121
Mailing address
85 N MEDICAL DR, SALT LAKE CITY, UT 84112-1100
(801) 581-2121
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
14172601-1204
UT
Other
Enumeration date
01/21/2021
Last updated
11/07/2024
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