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1043986888
GRANT MICHAEL BLACK
LONGMONT, CO
NPI
1043986888
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: CO PTL.0017868)
Enumeration Date
2021-08-20
Last Update Date
2024-09-16
Business Address
GRANT MICHAEL BLACK PT, DPT
1610 DRY CREEK DR
LONGMONT, CO 80503-6405
Phone number: 720-494-4750
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Mailing Address
GRANT MICHAEL BLACK PT, DPT
1610 DRY CREEK DR
LONGMONT, CO 80503-6405
Phone number: 720-494-4750
Copy
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