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Individual

MARTHA BLODGETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5532 JFK BLVD, NORTH LITTLE ROCK, AR 72116-6708
(501) 588-3211
(501) 353-2599
Mailing address
PO BOX 333, WARD, AR 72176-0333
(501) 588-3211
(501) 353-2599

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2900
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
213653721
AR
Enumeration date
03/01/2016
Last updated
02/21/2019
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