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General NPI Number Information
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NPI Number | 1255780524
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Entity Type | Organization
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Legal Business Name | BLAIR INVESTMENTS
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 06/08/2016
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Provider Practice Location Address
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Address Line | 1331 PRAIRIE AVE
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City | CHEYENNE
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State | WY
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Zip | 82009-4867
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Country | US
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Telephone | 307-637-4617
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Fax |
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Provider Business Mailing Address
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Address Line | 1541 CENTENNIAL CT
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City | CASPER
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State | WY
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Zip | 82609-7304
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Country | US
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Telephone | 307-235-3910
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KATHY BLAIR
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Credential | DPT
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Telephone | 307-235-3910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1629
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License Number State | WY
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