=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912052242
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLAIR INVESTMENTS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/25/2007
-----------------------------------------------------
Last Update Date | 07/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4020 LARAMIE ST
-----------------------------------------------------
City | CHEYENNE
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82001-2064
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-637-4617
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1541 CENTENNIAL CT
-----------------------------------------------------
City | CASPER
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82609-7304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-235-3910
-----------------------------------------------------
Fax | 307-637-3568
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | KATHY JEAN BLAIR
-----------------------------------------------------
Credential | PT
-----------------------------------------------------
Telephone | 307-235-3910
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------