Gary Edward Black, LMP

NPI #1427452572 in Tumwater, Washington

Provider Information

NPI Number: 1427452572
Entity Type: Individual
Name: Gary Edward Black, LMP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Credential: LMP
Enumeration Date: Oct 17, 2014
Last Updated: Oct 17, 2014

Practice Location

Address: 205 CLARK PL SE
City: Tumwater
State: Washington
ZIP Code: 98501-4062
Phone: (360) 570-0401

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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