Kelly Black, PT

NPI #1629527049 in Ozark, Missouri

Provider Information

NPI Number: 1629527049
Entity Type: Individual
Name: Kelly Black, PT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Sep 27, 2016
Last Updated: Sep 27, 2016

Practice Location

Address: 1114 W JACKSON ST
City: Ozark
State: Missouri
ZIP Code: 65721-9164
Phone: (417) 581-1234

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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