Individual
BRADLEY JACOB BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, RN, CRNA
Contact information
Practice address
907 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5015
(865) 380-9070
(865) 380-9093
Mailing address
PO BOX 24776, CHATTANOOGA, TN 37422-4776
(877) 288-1799
(855) 917-2023
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
180244
TN
Other
Enumeration date
09/23/2015
Last updated
11/10/2015
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