Stephanie Blake, ATC/LAT

NPI #1144710815 in Walnut Ridge, Arkansas

Provider Information

NPI Number
1144710815
Entity Type
Individual
Name
Stephanie Blake, ATC/LAT
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Specialist/Technologist - Athletic Trainer
Credential
ATC/LAT
Enumeration Date
May 17, 2018
Last Updated
May 17, 2018

Practice Location

Address
60 W FULBRIGHT ST
ZIP Code
72476-9000
Phone
(870) 208-5631

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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