Tru Blake

NPI #1215617360 in Detroit Lakes, Minnesota

Provider Information

NPI Number: 1215617360
Entity Type: Individual
Name: Tru Blake
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Jul 24, 2023
Last Updated: Jul 24, 2023

Practice Location

Address: 1041 HAWK ST
City: Detroit Lakes
State: Minnesota
ZIP Code: 56501-6958
Phone: (218) 287-4338

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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