Johnson, Blair
Johnson, Blair is an individual health care provider with primary practice located at 1815 E Ireland Rd Ste 100 , South Bend IN 46614-2845. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as his primary health care specialty. Johnson, Blair can be contacted via phone (574) 647-5790.Contact Information
Primary practice address
1815 E Ireland Rd Ste 100
South Bend IN 46614-2845
Phone: (574) 647-5790
Fax: (574) 647-5792
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic | 2251X0800X | 36000299A | Indiana |
Profile Details
| NPI number | 1538553797 |
|---|---|
| LBN Legal business name | Johnson, Blair |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 26th, 2015 |
| Last updated | Mar 31st, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538553797 | NPPES |
| Indiana | MEDICAID | 201284010 |
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