Individual
ED BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2111 HILLSIDE RD UNIT 3204, STORRS, CT 06269-9179
(860) 486-3046
Mailing address
2111 HILLSIDE RD UNIT 3204, STORRS, CT 06269-9179
(860) 486-3046
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000639
CT
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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