Individual
GAGE BLANKENSHIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1707 LINWOOD DR STE G1707, PARAGOULD, AR 72450-5364
(870) 604-4455
Mailing address
1707 LINWOOD DR STE G1707, PARAGOULD, AR 72450-5364
(870) 604-4455
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/20/2023
Last updated
10/20/2023
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