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Individual

ERNESTINE TINA BLAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
500 VILLAGE ROAD, BRECKENRIDGE, CO 80424
(303) 505-7763
Mailing address
PO BOX 460301, AURORA, CO 80046-0301
(303) 505-7763

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0025655
CO

Other

Enumeration date
02/27/2025
Last updated
03/11/2026
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