Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 2002005858 | MO |
NPI | 1013027549 |
---|---|
Provider Name | Anna-Katherine Blair |
First Address | Ferguson, MO 63136-2405 |
Second Address | Ferguson, MO 63136-2405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 27/06/2011 |