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Individual

DR. NUTTA-ON BLAIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, PHD

Contact information

Practice address
6475 JIMMY CARTER BLVD STE 200, NORCROSS, GA 30071-1734
(770) 242-7744
(770) 368-0164
Mailing address
315 ROLLING MIST CT, ALPHARETTA, GA 30022-4405
(414) 324-1176

Taxonomy

Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
PT013222
GA
2251N0400X
Neurology Physical Therapist
PTL.0014385
CO
2251P0200X
Pediatric Physical Therapist
PT013222
GA
2251P0200X
Pediatric Physical Therapist
PTL.0014385
CO

Other

Enumeration date
11/29/2017
Last updated
11/29/2017
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