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1952187130
ALYSSA NICHOLE BLACK
PROVO, UT
NPI
1952187130
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-09-05
Last Update Date
2023-09-05
Business Address
ALYSSA NICHOLE BLACK
750 N FREEDOM BLVD STE 300
PROVO, UT 84601-1690
Phone number: 801-373-4760
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Mailing Address
ALYSSA NICHOLE BLACK
750 N FREEDOM BLVD STE 300
PROVO, UT 84601-1690
Phone number: 801-373-4760
Copy
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