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1073631149
MELISSA OLSON BLACK
GOOCHLAND, VA
NPI
1073631149
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VA 0126000030)
Enumeration Date
2007-03-27
Last Update Date
2012-12-21
Business Address
Mrs. MELISSA OLSON BLACK M.S., A.T.C.
3250 RIVER ROAD WEST
GOOCHLAND, VA 23063
Phone number: 804-556-5322
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Mailing Address
Mrs. MELISSA OLSON BLACK M.S., A.T.C.
5004 TORI LN
GOOCHLAND, VA 23063-2115
Phone number: 804-306-4268
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