Provider Demographics
NPI:1295886471
Name:SALLING, BLAIR CROWDER (MPT)
Entity type:Individual
Prefix:MRS
First Name:BLAIR
Middle Name:CROWDER
Last Name:SALLING
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 E OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:WRIGHTSVILLE BEACH
Mailing Address - State:NC
Mailing Address - Zip Code:28480-1884
Mailing Address - Country:US
Mailing Address - Phone:910-297-2975
Mailing Address - Fax:
Practice Address - Street 1:1140 SHIPYARD BLVD
Practice Address - Street 2:COASTAL PHYSICAL THERAPY
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6439
Practice Address - Country:US
Practice Address - Phone:910-799-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9077225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist