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Individual
MICHAEL P BLAIR
Active
Individual
MICHAEL P BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305207779
VA
225100000X
Physical Therapist
PT1147
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121814000
—
WY
01
—
313920
BLUE CROSS BLUE SHIELD
WY
01
—
P00250413
RAILROAD MEDICARE
WY
Enumeration date
03/24/2006
Last updated
03/18/2014
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