Bevan D Blake, PT, DPT
NPI #1114928868 in Salt Lake City, Utah
Provider Information
- NPI Number
- 1114928868
- Entity Type
- Individual
- Name
- Bevan D Blake, PT, DPT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physical Therapist
- Credential
- PT, DPT
- Enumeration Date
- Aug 3, 2005
- Last Updated
- Oct 10, 2012
Practice Location
- Address
- 370 E SOUTH TEMPLE
- Address 2
- #250
- City
- Salt Lake City
- State
- Utah
- ZIP Code
- 84111-1206
- Phone
- (801) 512-2656
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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