JACKIE BLAKE
Individual Provider (NPI-1)
Active
Physical Therapist
Provider Information
- NPI Number
1225537269- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1 COMMUNITY ST, WHEELING, WV, 260035201
- Phone
- (304) 242-3933
Specialties & Taxonomies
Physical Therapist
Primary License: WV #001182
All Addresses
MAILING
100 SUGAR AVE
MOUNDSVILLE, WV, 260411287