Provider Demographics
NPI:1205594165
Name:BLAIR, DYLAN JAMES (PT, DPT)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:JAMES
Last Name:BLAIR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14000 E ARAPAHOE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4044
Mailing Address - Country:US
Mailing Address - Phone:720-497-6110
Mailing Address - Fax:720-497-6739
Practice Address - Street 1:14000 E ARAPAHOE RD STE 110
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-4044
Practice Address - Country:US
Practice Address - Phone:720-497-6110
Practice Address - Fax:720-497-6739
Is Sole Proprietor?:No
Enumeration Date:2021-12-07
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10963225100000X
AZ10963225100000X
COCP032538T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist