Amie Miquelle Black

NPI #1225429590 in West Jordan, Utah

Provider Information

NPI Number: 1225429590
Entity Type: Individual
Name: Amie Miquelle Black
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Feb 9, 2015
Last Updated: Feb 9, 2015

Practice Location

Address: 1990 W 7800 S
City: West Jordan
State: Utah
ZIP Code: 84088-4025
Phone: (801) 748-1229

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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