MIKE BLACK

RIVERTON, UT
NPI1326436007
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: UT  9255052-2401)
Enumeration Date2015-01-02
Last Update Date2015-01-02
Business Address
-- MIKE BLACK DPT
12391 S 4000 W #210
RIVERTON, UT 84096-7012
Phone number: 801-446-0990
Mailing Address
-- MIKE BLACK DPT
9720 S 1300 E #W200
SANDY, UT 84094-3712
Phone number: 801-230-2376
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