Provider Demographics
NPI:1942911839
Name:HOOVER, BLAKE (DC)
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:
Last Name:HOOVER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:BLAKE
Other - Middle Name:
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:6822 BURGUNDY AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-6840
Mailing Address - Country:US
Mailing Address - Phone:330-868-8966
Mailing Address - Fax:
Practice Address - Street 1:1837 STEESE RD STE B
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-9555
Practice Address - Country:US
Practice Address - Phone:330-868-8966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor