Individual
MATTHEW BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3514 N FOWLER AVE, SILVER CITY, NM 88061-7210
(575) 388-3127
Mailing address
PO BOX 427, NORA, IL 61059-0427
(608) 228-1721
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
06006588A
IN
225200000X
Physical Therapy Assistant
10061
MA
225200000X
Physical Therapy Assistant
2349
CT
225200000X
Physical Therapy Assistant
2561-19
WI
225200000X
Physical Therapy Assistant
Primary
PT-2023-2389
NM
Other
Enumeration date
10/17/2016
Last updated
12/20/2023
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