Most Relevant Information
Provider Data
| NPI Number: | 1003402546 |
| Provider Name: | SANDRA BLAKE |
| Entity Type: | Individual |
| Taxonomy Code: | 376J00000X |
| Specialty: | Homemaker |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/18/2020 |
| Last Updated: | 12/18/2020 |
Provider Practice Location
8 N SPRING ST
BUCKHANNON
WV
262012720
Practice Location Phone/Fax
| Phone: | 3044720395 |
| Fax: | 3044712488 |
Provider Mailing Location
125 MULBERRY AVE
WESTON
WV
264521521
Provider Mailing Phone/Fax
| Phone: | 3044767918 |
| Fax: |