Provider Demographics
NPI:1144296260
Name:BLACKMORE-HAUS, MARGARET ANN (ATC)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:ANN
Last Name:BLACKMORE-HAUS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
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Mailing Address - Street 1:210 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40769-1321
Mailing Address - Country:US
Mailing Address - Phone:606-549-0929
Mailing Address - Fax:606-539-4126
Practice Address - Street 1:7790 COLLEGE STATION DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:KY
Practice Address - Zip Code:40769-1388
Practice Address - Country:US
Practice Address - Phone:606-539-4131
Practice Address - Fax:606-539-4126
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer