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Contact Information

CHARLES BLAKE, PT
MONCRIEF ARMY HEALTH CLINIC
4500 8TH DIVISION DRIVE
COLUMBIA, SC29207
 Phone: 803-751-7183
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for CHARLES BLAKE · (Male)

NPI Number 1104892637
Status Active
Credentials PT (Physical Therapist)
Entity Individual
Enumeration date 02/24/2006
Last updated 03/18/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • TN License # 420820
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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