IndividualActive
Charles Blake, PT
NPI 1104892637 · Orthopedic Physical Therapist · Columbia, SC
Provider details
- NPI number
- 1104892637
- Entity type
- Individual
- Primary specialty
- Orthopedic Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Male
- Sole proprietor
- No
- License
- 420820 (TN)
Practice location
Moncrief Army Health Clinic
4500 8th Division Drive
Columbia, SC 29207
Phone: (803) 751-7183
Mailing address
Moncrief Army Health Clinic
Columbia, SC 29207
Registry dates
- Enumerated
- 2006-02-24
- Last updated
- 2025-03-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.