Doctor Name: | BLAKE ARTHUR PUGH |
NPI Number: | 1134314107 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | PT9191 |
Business Practice Address: | 150 Medical Way Suite E1 Riverdale, GA - 302742533 |
Business Phone Number: | 7709912747 |
Business Fax Number: | 7709911704 |
Mailing Address: | 8823 Production Ln, OOLTEWAH |
State: | TN |
Postal Code: | 373636511 |
Phone Number: | 4232387217 |
Fax Number: | 4232383473 |
NPI Enumeration Date: | 09/12/2007 |
NPI Last Update Date: | 02/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT9191 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |