MEDICARE: DANIEL P BLAIR DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	8734	SC

General Provider Information

NPI Number	:	1316369788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL P BLAIR DPT

Provider Business Mailing Address
First Line	:	3800 FOREST DR STE B101
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4146
Country	:	US
Telephone Number	:	803-764-2363
Fax Number	:	803-550-9389

Provider Business Practice Location Address
First Line	:	3800 FOREST DR STE B101
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-4146
Country	:	US
Telephone Number	:	803-764-2363
Fax Number	:	803-550-9389

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2014
Last Update Date	:	11/05/2025

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