Individual
CHAD BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
535 N LOCUST GROVE RD STE 170, MERIDIAN, ID 83642-9379
(208) 917-2660
Mailing address
2000 S WHITE PINE LN, BOISE, ID 83706-4047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT7219
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT7219
STATE LICENSE
ID
Enumeration date
05/27/2021
Last updated
05/27/2021
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