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NPI Code Detail

MEDICARE: SHELLEY BLANKSTEEN P.T.

MEDICARE: SHELLEY BLANKSTEEN P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2635AR

General Provider Information

NPI Number : 1578521332
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY BLANKSTEEN P.T.
Provider Business Mailing Address
First Line : 2740 COLLEGE AVE
Second Line :
City : CONWAY
State : AR
Zip : 72034-6141
Country : US
Telephone Number : 501-329-5459
Fax Number : 501-327-1738
Provider Business Practice Location Address
First Line : 1900 ALDERSGATE RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-6620
Country : US
Telephone Number : 501-821-5459
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2006
Last Update Date : 02/24/2022

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Directions to “ SHELLEY BLANKSTEEN P.T.” Practice Location

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