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Contact Information

BLAKE A HARRIS
4881 SUGAR MAPLE DR
WRIGHT-PATTERSON AFB, OH45433-5529
 Phone: 937-257-9046
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist/Technologist, Other

246Z00000X
Indicates primary specialty

NPI Profile & details for BLAKE A HARRIS · (Male)

NPI # 1487484259
Status Active
Credentials
Entity Individual
Enumeration date 08/06/2024
Last updated 08/06/2024 - More than a year ago
Sole proprietor 1 No
Identifiers Not Available
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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