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1790413359
CHRISTOPHER BLACK
DRAPER, UT
NPI
1790413359
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: UT 9152128-4405)
Enumeration Date
2022-08-11
Last Update Date
2022-08-11
Business Address
CHRISTOPHER BLACK APRN
13020 S FORT ST
DRAPER, UT 84020-9294
Phone number: 801-361-2225
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Mailing Address
CHRISTOPHER BLACK APRN
1072 E 920 N
OREM, UT 84097-4327
Phone number: 801-361-2255
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