| NPI | 1669603809 |
|---|---|
| Other Name | HEATHER LYNN BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WV PT004683) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305205991) |
| 225100000X Physical Therapist (Licence: NV 2976) | |
| 225100000X Physical Therapist (Licence: CA 29537) | |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2023-11-21 |