Mike Black, DPT

NPI #1326436007 in Riverton, Utah

Provider Information

NPI Number: 1326436007
Entity Type: Individual
Name: Mike Black, DPT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Jan 2, 2015
Last Updated: Jan 2, 2015

Practice Location

Address: 12391 S 4000 W
Address 2: #210
City: Riverton
State: Utah
ZIP Code: 84096-7012
Phone: (801) 446-0990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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