Blake, Thomas Leon

Blake, Thomas Leon is an sole proprietor health care provider with primary practice located at 104 North Greensboro Street , Liberty NC 27298-3203. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Blake, Thomas Leon can be contacted via phone (336) 622-1600.

Contact Information

Primary practice address
104 North Greensboro Street Liberty NC 27298-3203
Phone: (336) 622-1600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 2074 North Carolina

Profile Details

NPI number 1013075746
LBN Legal business name Blake, Thomas Leon
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 5th, 2006
Last updated Aug 24th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013075746 NPPES
North Carolina MEDICAID 890830H

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