Individual
BLAKE J WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1443 SPYGLASS PL, MANTECA, CA 95336-2715
(209) 305-6021
Mailing address
1443 SPYGLASS PL, MANTECA, CA 95336-2715
(209) 305-6021
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
225400000X
CA
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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