Individual
ALEXA BLAIRE GRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 S 52ND ST, ROGERS, AR 72758-8600
(479) 254-9662
(806) 701-5845
Mailing address
500 S 52ND ST, ROGERS, AR 72758-8600
(479) 254-9662
(479) 254-9662
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-922
AR
Other
Enumeration date
11/06/2017
Last updated
08/28/2020
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