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General NPI Number Information
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NPI Number | 1518687052
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Entity Type | Individual
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Provider Name | MICHAEL DAVID BLAIR PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/02/2022
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 111 FOX RD STE 101
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City | KNOXVILLE
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State | TN
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Zip | 37922-9000
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Country | US
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Telephone | 865-351-0615
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Fax | 865-622-9566
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Provider Business Mailing Address
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Address Line | 564 OAK RIDGE TURNPIKE
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City | OAK RIDGE
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State | TN
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Zip | 37830-7164
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Country | US
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Telephone | 865-213-2744
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Fax | 865-315-7033
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 14357
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License Number State | TN
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