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Contact Information

STEPHANIE D BLAKE, DPT
621 W 21ST ST
ANDOVER, KS67002-8498
 Phone: 316-733-1349
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for STEPHANIE D BLAKE · (Female)

NPI Number 1003124769
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 09/15/2010
Last updated 09/15/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • KS License # 11-04112
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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