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1821876269
LANEY REVAE BLANKENSHIP
PARAGOULD, AR
NPI
1821876269
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: AR PTA4834)
Enumeration Date
2023-09-18
Last Update Date
2023-09-18
Business Address
LANEY REVAE BLANKENSHIP
115 N 14TH ST
PARAGOULD, AR 72450
Phone number: 870-476-9017
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Mailing Address
LANEY REVAE BLANKENSHIP
2903 STONEGATE DRIVE
PARAGOULD, AR 72450
Phone number: 870-450-1413
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