Individual
MAKAYLA STEPHANIE BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7915 N 30TH ST, OMAHA, NE 68112-2418
(402) 827-6000
Mailing address
1887 N 150TH PLZ, OMAHA, NE 68154-1055
(402) 210-5920
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1838
NE
Other
Enumeration date
09/04/2021
Last updated
09/04/2021
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