STEPHANIE BLAKE

WALNUT RIDGE, AR
NPI1144710815
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: AR  AT701)
Enumeration Date2018-05-17
Last Update Date2018-05-17
Business Address
STEPHANIE BLAKE ATC/LAT
60 W FULBRIGHT ST
WALNUT RIDGE, AR 72476-9000
Phone number: 870-208-5631
Mailing Address
STEPHANIE BLAKE ATC/LAT
211 FAIRGROUNDS RD
HARRISBURG, AR 72432-1306
Phone number:
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