Individual ProviderBlake SpoonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2806 N Main St, Victoria, TX 77901-3216(361) 237-1670PECOS EnrollmentBased on the most recent information from CMS, provider Blake Spoon does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1356717110Provider TypeIndividualFull NameSpoon, BlakeTitleDr.CredentialPTGenderMaleSole ProprietorNoEnumeration Date8/17/2015Last Updated8/17/2015Contact InformationPractice LocationPractice Address2806 N Main St, Victoria, TX 77901-3216Phone(361) 237-1670Fax(361) 237-1703Mailing LocationMailing Address2806 N Main St, Victoria, TX 77901-3216Phone(361) 237-1670Fax(361) 237-1703Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1263602Texas