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1912776675
BRIAN BLACK
SEATTLE, WA
NPI
1912776675
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: WA P1.160852132)
Enumeration Date
2023-12-22
Last Update Date
2023-12-22
Business Address
BRIAN BLACK PTA
820 NW 95TH ST
SEATTLE, WA 98117-2207
Phone number: 206-782-0100
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Mailing Address
BRIAN BLACK PTA
1711 E OLIVE WAY APT 417
SEATTLE, WA 98102-5684
Phone number: 206-979-7939
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