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1366623191
CATHERINE R BLACK
PROVO, UT
NPI
1366623191
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: UT 198805-4405)
Enumeration Date
2007-11-20
Last Update Date
2014-03-21
Business Address
-- CATHERINE R BLACK
280 RIVER PARK DR SUITE 200
PROVO, UT 84604-5764
Phone number: 801-223-4860
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Mailing Address
-- CATHERINE R BLACK
280 RIVER PARK DR #200
PROVO, UT 84604-5764
Phone number: 801-223-4860
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