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1760511422
MICHEAL BLACK
SOUTH JORDAN, UT
NPI
1760511422
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: UT 261943-4701)
Enumeration Date
2007-03-05
Last Update Date
2007-07-08
Business Address
-- MICHEAL BLACK L.M.T.
10358 S REDWOOD RD
SOUTH JORDAN, UT 84095-9339
Phone number: 801-253-3158
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Mailing Address
-- MICHEAL BLACK L.M.T.
10358 S REDWOOD RD
SOUTH JORDAN, UT 84095-9339
Phone number: 801-253-3158
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