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Individual

BLAKE PEPPER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
300 GOOD SAMARITAN DR, MOUNTAIN HOME, AR 72653-5813
(870) 404-7835
Mailing address
300 GOOD SAMARITAN DR, MOUNTAIN HOME, AR 72653-5813
(870) 404-7835

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3914
AR

Other

Enumeration date
03/06/2020
Last updated
03/06/2020
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