Individual
MRS. JACKIE LYNN BLAIR-MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1400 S DOBSON RD, MESA, AZ 85202-4707
(480) 512-3627
Mailing address
1950 E SPRINGFIELD PL, CHANDLER, AZ 85286-1432
(480) 857-9597
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3062
AZ
Other
Enumeration date
01/21/2008
Last updated
01/21/2008
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