Kimberly Thornton Blake, PA

NPI #1295030195 in Sanford, Florida

Provider Information

NPI Number
1295030195
Entity Type
Individual
Name
Kimberly Thornton Blake, PA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Credential
PA
Enumeration Date
Jan 24, 2011
Last Updated
Jan 24, 2011

Practice Location

Address
1401 W SEMINOLE BLVD
State
Florida
ZIP Code
32771-6743
Phone
(800) 893-9698

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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