Blake Church, OD

NPI #1104717024 in New Berlin, Wisconsin

Provider Information

NPI Number: 1104717024
Entity Type: Individual
Name: Blake Church, OD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jul 9, 2025
Last Updated: Aug 3, 2025

Practice Location

Address: 16800 W CLEVELAND AVE
City: New Berlin
State: Wisconsin
ZIP Code: 53151-3533
Phone: (414) 313-7121

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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