Leslie C Blankenship, L.P.T.A.

Individual provider Active NPI Physical Therapy Assistant · Corning, AR

NPI 1770628919 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1770628919
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA959 (AR)
Practice address
1700 W Main St
Corning, AR 72422-1903
Phone
(870) 857-0049
Fax
(870) 857-3027
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA959ARMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pendergrass Therapy Services, Inc. Past
since Jan 1, 2001
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA959 AR Yes

Addresses

Primary practice location

1700 W Main St
Corning, AR 72422-1903

Mailing address

1700 W Main St
Corning, AR 72422-1903
Phone (870) 857-0049

Other providers in Corning, AR

All providers in Corning, AR · Physical Therapy Assistant in Arkansas

Sources for this page

Verify at the official NPI Registry.