MIKE A BLACK

SALT LAKE CITY, UT
NPI1942716998
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology
(Licence: DC  161255)
Additional Taxonomies146N00000X Emergency Medical Technician, Basic
(Licence:   E1160515)
246W00000X Technician, Cardiology
(Licence: WA  60434882)
Enumeration Date2017-12-28
Last Update Date2019-05-03
Business Address
MIKE A BLACK CEPS, NREMT
4989 S STATE ST UNIT 57768
SALT LAKE CITY, UT 84157-5032
Phone number: 916-217-1584
Mailing Address
MIKE A BLACK CEPS, NREMT
PO BOX 57768
MURRAY, UT 84157-0768
Phone number: 916-217-1584