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ED BLAIR ATC

Athletic Trainer >> Specialist/Technologist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1326528852

Individual Registrant:
 ED  BLAIR ATC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2111 HILLSIDE RD UNIT 3204  STORRS, CT 06269-9179 US
Tel: 860-486-3046  Fax: --

Contact information for business:
2111 HILLSIDE RD UNIT 3204  STORRS, CT 06269-9179 US
Tel: 860-486-3046  Fax: --

Registration Information:
NPI: 1326528852
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Specialist/Technologist
Athletic Trainer
CT000639

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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