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Individual

CAMERON BLAKE FORTENBERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
16100 CHENAL VALLEY DR, LITTLE ROCK, AR 72223-4042
(501) 267-9554
Mailing address
701 RAHLING RD APT 1402, LITTLE ROCK, AR 72223-5292
(601) 896-4333

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA5036
AR

Other

Enumeration date
04/30/2026
Last updated
04/30/2026
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