BEVAN BLAKE, PT, DPT

Physical Therapist

Active Individual
NPI: 1114928868

Practice Address

370 E SOUTH TEMPLE
#250
Salt Lake City, UT 84111

Phone: (801) 512-2656

Specialties

Specialty Code Primary License
Physical Therapist 225100000X Yes 344859-2401 (UT)

Frequently Asked Questions

NPI 1114928868 is the National Provider Identifier for BEVAN BLAKE, PT, DPT, a Physical Therapist provider located in Salt Lake City, UT. This NPI was enumerated on August 3, 2005.
BEVAN BLAKE, PT, DPT practices at 370 E SOUTH TEMPLE, #250, Salt Lake City, UT 84111.

Quick Facts

NPI
1114928868
Type
Individual
Enumerated
Aug 3, 2005
Last Updated
Oct 10, 2012

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