Provider Demographics
NPI:1962137042
Name:BLAIR, FAITH JORDAN (DPT)
Entity type:Individual
Prefix:DR
First Name:FAITH
Middle Name:JORDAN
Last Name:BLAIR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:768 ROUTE 539 APT B
Mailing Address - Street 2:
Mailing Address - City:NEW EGYPT
Mailing Address - State:NJ
Mailing Address - Zip Code:08533-2000
Mailing Address - Country:US
Mailing Address - Phone:609-752-2938
Mailing Address - Fax:
Practice Address - Street 1:9151 NE 81ST TER STE 110
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1176
Practice Address - Country:US
Practice Address - Phone:816-415-4971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist