Individual
MRS. MERILEE GAMBLE BOOKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, MS, PCS
Contact information
Practice address
609 W MAPLE AVE, SPRINGDALE, AR 72764-5335
(479) 750-6240
(479) 750-6627
Mailing address
PO BOX 237, GOSHEN, AR 72735-0237
(479) 575-0404
(479) 575-0404
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT 1047
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59949
BLUE CROSS BLUE SHIELD
AR
Enumeration date
05/07/2007
Last updated
07/08/2007
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