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NPI Code Detail

MEDICARE: MR. MARK BLAKE PERCY LMT

MEDICARE:  MR. MARK BLAKE PERCY  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist68824CA

General Provider Information

NPI Number : 1790446870
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK BLAKE PERCY LMT
Provider Business Mailing Address
First Line : 8741 ABERDEEN RD
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70127-1507
Country : US
Telephone Number : 504-509-8015
Fax Number :
Provider Business Practice Location Address
First Line : 8741 ABERDEEN RD
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70127-1507
Country : US
Telephone Number : 504-509-8015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2021
Last Update Date : 12/31/2021

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Directions to “ MR. MARK BLAKE PERCY LMT” Practice Location

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