Individual
MR. BLAKE HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5000
Mailing address
533 FRONT ST APT 306, NORFOLK, VA 23510-1080
(925) 915-0170
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
VA
Other
Enumeration date
09/10/2025
Last updated
09/10/2025
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