1. Home
  2. Directory
  3. Georgia
  4. Norcross
  5. Physical Therapist
  6. NPI Profile

DR. NUTTA-ON BLAIR PT, PHD
NPI 1508370453
Physical Therapist - Neurology in Norcross, GA

Active since November 29, 2017
6475 JIMMY CARTER BLVD STE 200, NORCROSS, GA 30071(770) 242-7744(770) 368-0164 Get Directions Write a Review

NPPES record last updated: November 29, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Nutta-on Blair Pt, Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NUTTA-ON BLAIR PT, PHD (NPI 1508370453) is an individual neurology provider in Norcross, Georgia, licensed in Georgia (PT013222) and active in the NPI registry since November 2017.

NPPES Registry Identity

NPI1508370453
Entity TypeIndividualFemale
Primary Taxonomy2251N0400X
Provider Legal NameDR. NUTTA-ON BLAIRCredential: PT, PHD
Location Address6475 JIMMY CARTER BLVD STE 200Norcross, GA 30071-1734
Mailing Address315 Rolling Mist CtAlpharetta, GA 30022-4405 · (414) 324-1176
Phone(770) 242-7744
Fax(770) 368-0164
Sole ProprietorYes
Enumeration DateNovember 29, 2017
✔ NPI 1508370453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Therapist · NeurologyRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251N0400X
Licenses✔ Licensed in GA · PT013222✔ Licensed in CO · PTL.0014385
Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Neurologic Physical Therapy, who has demonstrated specialized knowledge and skill in neuroanatomy and neurophysiology, including knowledge of central, peripheral, and autonomic nervous systems in populations with and without neurologic conditions; motor control and movement sciences in populations with and without neurologic conditions; behavioral sciences, including psychology and neuropsychology, and psychiatry; and medical management and pharmacology.

Also ListedPhysical Therapist · PediatricsTaxonomy 2251P0200X · License PT013222 (GA), PTL.0014385 (CO)
6475 JIMMY CARTER BLVD STE 200, Norcross, GA 30071
Open in Google Maps ↗

Other Names 1

Former Name (1)Nutta-on Promjunyakul Pt, Phd

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIM LAM DPT
Physical Therapist
6475 JIMMY CARTER BLVD STE 200
NORCROSS, GA 30071
Gwinnett County (770) 242-7744
MELISSA TUCKER KHAN PA-C
Physician Assistant
6475 JIMMY CARTER BLVD STE 200
NORCROSS, GA 30071
Gwinnett County (770) 242-7744
CLAIRE CAMILLE PAVLICH PT, DPT
Physical Therapist
6475 JIMMY CARTER BLVD STE 200
NORCROSS, GA 30071
Gwinnett County (717) 972-1100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nutta-on Blair's NPI number?

The NPI number for Nutta-on Blair is 1508370453. It was assigned to this individual provider in the NPPES registry on November 29, 2017. The provider is also known as Nutta-On Promjunyakul Pt, Phd.

Where is Nutta-on Blair located?

Nutta-on Blair practices at 6475 Jimmy Carter Blvd Ste 200, Norcross, GA 30071. The listed phone number is (770) 242-7744.

What is Nutta-on Blair's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Neurology, with taxonomy code 2251N0400X.

When was this NPI record last updated?

The NPPES record for Nutta-on Blair was last updated on November 29, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.