Individual
MRS. KELLY ANN BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
410 N KROCKS RD, ALLENTOWN, PA 18106-9283
(888) 982-8594
(888) 982-8594
Mailing address
PO BOX 159, BARRINGTON, NJ 08007-0159
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0003708
MD
Other
Enumeration date
01/24/2008
Last updated
02/16/2023
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