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General NPI Number Information
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NPI Number | 1760405799
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Entity Type | Individual
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Provider Name | KRISTY ANN BLAIR PT
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 240 WALL ST SUITE 100
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1181
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Country | US
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Telephone | 732-222-8556
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Fax | 732-222-8663
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Provider Business Mailing Address
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Address Line | 2209 KILKARE PKWY
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City | POINT PLEASANT BORO
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State | NJ
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Zip | 08742-3818
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Country | US
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Telephone | 732-892-1756
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Fax |
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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 | 40QA01032300
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License Number State | NJ
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