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Individual

BLAKE EDWARD FORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3535 SOUTHER BOULEVARD, KETTERING, OH 45419
(937) 298-4331
Mailing address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(513) 465-4217

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
008790
OH

Other

Enumeration date
11/01/2022
Last updated
11/01/2022
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