Dakota Storm Blake, PTA

NPI #1417594748 in Fort Edward, New York

Provider Information

NPI Number: 1417594748
Entity Type: Individual
Name: Dakota Storm Blake, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Dec 5, 2019
Last Updated: Dec 5, 2019

Practice Location

Address: 319 BROADWAY
City: Fort Edward
State: New York
ZIP Code: 12828-1221
Phone: (518) 746-0700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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