Michael Jack Blake, DPT
Physical Therapist in Castle Rock, CO. Individual provider (NPI-1).
NPI number1295560100
StatusActive
Last updated in NPPESAug 5, 2025
Details
- NPI
- 1295560100
- Entity type
- Individual (NPI-1)
- Name
- Michael Jack Blake
- Credential
- DPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 3, 2024
- Certification date
- Aug 5, 2025
- Last updated
- Aug 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 20757 | CO | Yes |
| 225100000X | Physical Therapist | 5501303478 | MI |
Practice location
390 S Wilcox St Ste BCastle Rock, CO 80104-1951
Phone 303-839-8068 · Fax 303-835-3597
Mailing address
390 S Wilcox St Ste BCastle Rock, CO 80104-1951
Phone 303-839-8068 · Fax 303-835-3597
Other practice locations
7402 Westshire Dr
Lansing, MI 48917-8988
Lansing, MI 48917-8988
Phone 517-853-6800
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All 116 Physical Therapist providers in Castle Rock · All 1,947 providers in Castle Rock
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