Provider Demographics
NPI:1427563840
Name:TRESSLER, BLAKE EDWARD (DC)
Entity Type:Individual
Prefix:MR
First Name:BLAKE
Middle Name:EDWARD
Last Name:TRESSLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:BLAKE
Other - Middle Name:EDWARD
Other - Last Name:TRESSLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:158 W CARACAS AVE
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1510
Mailing Address - Country:US
Mailing Address - Phone:717-533-6100
Mailing Address - Fax:717-534-1957
Practice Address - Street 1:158 W CARACAS AVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1510
Practice Address - Country:US
Practice Address - Phone:717-533-6100
Practice Address - Fax:717-534-1957
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-07
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC011310111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor