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General NPI Number Information
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NPI Number | 1003525742
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Entity Type | Individual
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Provider Name | BLAIR ASHTON MILLER OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 700 MAIN ST
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City | RISON
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State | AR
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Zip | 71665-9563
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Country | US
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Telephone | 870-325-6241
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Fax |
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Provider Business Mailing Address
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Address Line | 12910 HIGHWAY 63
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City | RISON
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State | AR
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Zip | 71665-8122
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Country | US
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Telephone | 870-267-3527
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OTR3737
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License Number State | AR
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