Provider Demographics
NPI:1083916993
Name:BLAIR, DONALD ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ROBERT
Last Name:BLAIR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BURNS ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-2118
Mailing Address - Country:US
Mailing Address - Phone:406-291-5644
Mailing Address - Fax:
Practice Address - Street 1:1000 BURNS ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-2118
Practice Address - Country:US
Practice Address - Phone:406-291-5644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor