Michael P Blair, MSPT | |
6035 Burke Centre Pkwy, #300, Burke, VA 22015-3750 | |
(703) 978-3300 | |
Not Available |
Full Name | Michael P Blair |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 6035 Burke Centre Pkwy, Burke, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215997184 | NPI | - | NPPES |
313920 | Other | WY | BLUE CROSS BLUE SHIELD |
P00250413 | Other | WY | RAILROAD MEDICARE |
121814000 | Medicaid | WY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT1147 (Wyoming) | Secondary |
225100000X | Physical Therapist | 2305207779 (Virginia) | Primary |
Provider Name | Ideal Wellness Pllc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1568819266 PECOS PAC ID: 7618259326 Enrollment ID: O20170112001797 |
Mailing Address | Practice Location Address |
---|---|
Michael P Blair, MSPT 6035 Burke Centre Pkwy, #300, Burke, VA 22015-3750 Ph: (703) 978-3300 | Michael P Blair, MSPT 6035 Burke Centre Pkwy, #300, Burke, VA 22015-3750 Ph: (703) 978-3300 |
Barbara Boyle, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6035 Burke Centre Pkwy, 300, Burke, VA 22015 Phone: 703-978-3300 Fax: 703-978-6216 | |
Sonia Borges, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6035 Burke Centre Pkwy, Burke, VA 22015 Phone: 703-978-3300 Fax: 703-978-6216 | |
Matthew Earl Flynn, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9710 Walthorne Ct, Burke, VA 22015 Phone: 207-420-6553 | |
Sydney Sawyer, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9409 K Old Burke Lake Rd, Burke, VA 22015 Phone: 703-425-1800 | |
Elizabeth Charlene Voth, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9409 Old Burke Lake Rd, Burke, VA 22015 Phone: 703-425-1800 | |
Legacy Healthcare Services, Inc Physical Therapist Medicare: Medicare Enrolled Practice Location: 9642 Burke Lake Rd, Burke, VA 22015 Phone: 703-543-7920 Fax: 703-543-7924 |