Blake, Dakota Storm

Blake, Dakota Storm is an individual health care provider with primary practice located at 319 Broadway , Fort Edward NY 12828-1221. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Blake, Dakota Storm can be contacted via phone (518) 746-0700.

Contact Information

Primary practice address
319 Broadway Fort Edward NY 12828-1221
Phone: (518) 746-0700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 012276-01 New York

Profile Details

NPI number 1417594748
LBN Legal business name Blake, Dakota Storm
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2019
Last updated Dec 5th, 2019 - about 6 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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