Healthcare Provider Details

I. General information

NPI: 1780005868
Provider Name (Legal Business Name): BLAIRE KUHNEY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2013
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 BROADWAY
EL CAJON CA
92021-5124
US

IV. Provider business mailing address

6256 ALVERTON DR
CARLSBAD CA
92009-3061
US

V. Phone/Fax

Practice location:
  • Phone: 619-441-8745
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: