David Blaine

NPI #1942017017 in Lorain, Ohio

Provider Information

NPI Number: 1942017017
Entity Type: Individual
Name: David Blaine
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: Dec 12, 2024
Last Updated: Dec 12, 2024

Practice Location

Address: 6140 S BROADWAY
City: Lorain
State: Ohio
ZIP Code: 44053-3821
Phone: (440) 233-7232

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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