Blake Jenkins, LDO

NPI 1801526850 · on the registry since 2022 · sole proprietor

Practice

Address: 240 Wal Mart Way
Maysville, KY 41056
Phone: (606) 759-0385
Fax: (606) 759-0259
Organisation at this address: Wal-Mart Stores East Lp
Wal-Mart Stores East, Lp
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 8

Registry record

Primary taxonomy: 156FX1800X
156FX1800X
Licence states on file: KY
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2022-06-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kentucky