Individual
AMANDA SUSON BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T,
Contact information
Practice address
1458 HENSLEY FARM RD, MARSHALL, AR 72650-8672
(870) 448-6232
Mailing address
1458 HENSLEY FARM RD, MARSHALL, AR 72650-8672
(870) 448-6232
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
PT 3102
AR
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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