Provider Demographics
NPI:1841693249
Name:BLAIR, STEVEN TRAVIS (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:TRAVIS
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 1:2419 W. MAIN ST. STE 4
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-3813
Mailing Address - Country:US
Mailing Address - Phone:406-577-2742
Mailing Address - Fax:406-577-2749
Practice Address - Street 1:2419 W. MAIN ST. STE 4
Practice Address - Street 2:SUITE B
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3813
Practice Address - Country:US
Practice Address - Phone:406-577-2742
Practice Address - Fax:406-577-2749
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTCHI-CHI-LIC-3410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor