Lyle H Black, MPT

NPI #1619144920 in Logan, Utah

Provider Information

NPI Number: 1619144920
Entity Type: Individual
Name: Lyle H Black, MPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: MPT
Enumeration Date: May 15, 2008
Last Updated: Sep 11, 2008

Practice Location

Address: 248 W 300 N
City: Logan
State: Utah
ZIP Code: 84321-3810
Phone: (435) 754-0277

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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