Provider Demographics
NPI:1093857690
Name:BLAIN, MARGARET JEAN (PT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JEAN
Last Name:BLAIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8705 STAGHORN DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242-3419
Mailing Address - Country:US
Mailing Address - Phone:502-426-3015
Mailing Address - Fax:
Practice Address - Street 1:9510 ORMSBY STATION RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4081
Practice Address - Country:US
Practice Address - Phone:502-253-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY000574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist