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1982183349
LESLIE BLACK
MEDFORD, OR
NPI
1982183349
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 02834)
Enumeration Date
2018-08-07
Last Update Date
2018-08-07
Business Address
LESLIE BLACK PT
1111 CRATER LAKE AVE
MEDFORD, OR 97504-6241
Phone number: 541-732-5037
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Mailing Address
LESLIE BLACK PT
1111 CRATER LAKE AVE
MEDFORD, OR 97504-6241
Phone number: 541-732-5037
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