Provider Demographics
NPI:1609697853
Name:FRANCIS, DOUGLAS BLAKE
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:BLAKE
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043-5647
Mailing Address - Country:US
Mailing Address - Phone:828-305-1870
Mailing Address - Fax:
Practice Address - Street 1:341 CHAPMAN RD
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-5647
Practice Address - Country:US
Practice Address - Phone:828-305-1870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP23595225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist