Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BLAKE CHURCH, OD
ActiveBLAKE CHURCH, OD is a Optometrist healthcare provider located in NEW BERLIN, Wisconsin. NPI 1104717024 is currently active in the NPPES registry. Verify at CMS.
Optometrist · NEW BERLIN, WI
Registration Details
- NPI Number
- 1104717024
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 9, 2025 (1.1332660462152 yrs)
- Last Updated
- Aug 3, 2025
- License
-
4089-35 (WI)
Practice Information
- Address
-
16800 W CLEVELAND AVENEW BERLIN, WI, 531513533Browse WI providers · Browse ZIP 53151
- Phone
- 4143137121
- Primary Specialty
-
Optometrist
152W00000X
Other Optometrist Providers in NEW BERLIN, WI
| Name | Credential | NPI |
|---|---|---|
| H CHAPMAN LEFFINGWELL | O.D. | 1548234123 |
| DAVE A. ZIEGLER | O.D. | 1770557076 |
| DR. THOMAS MOTISI | O.D. | 1417972589 |
| DR. JOHN W THORPE | OD | 1588724587 |
| DR. WILLIAM HENRY MYERS | O.D. | 1114130614 |
| DR. RYAN ROBERT LANG | O.D. | 1881957561 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.