Most Relevant Information
Provider Data
| NPI Number: | 1003242785 |
| Provider Name: | LUZ O BLAKE P.T. |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT28358 |
Most Important Dates
| Enumeration Date: | 09/25/2013 |
| Last Updated: | 10/01/2013 |
Provider Practice Location
15715 ROCKFIELD BOULEVARD
SUITE 100
IRVINE
CA
926182845
Practice Location Phone/Fax
| Phone: | 9492069100 |
| Fax: | 9492061648 |
Provider Mailing Location
15715 ROCKFIELD BOULEVARD
SUITE 100
IRVINE
CA
926182845
Provider Mailing Phone/Fax
| Phone: | 9492069100 |
| Fax: | 9492061648 |