Individual
BRIAN DOUGLAS BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 E. JACKSON, JONESBORO, AR 72401
(870) 972-4309
Mailing address
2210 TWIN OAKS, JONESBORO, AR 72401
(870) 219-0100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2380
AR
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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