Micheal Black, L.M.T.
NPI #1760511422 in South Jordan, Utah
Provider Information
- NPI Number
- 1760511422
- Entity Type
- Individual
- Name
- Micheal Black, L.M.T.
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Massage Therapist
- Credential
- L.M.T.
- Enumeration Date
- Mar 5, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 10358 S REDWOOD RD
- City
- South Jordan
- State
- Utah
- ZIP Code
- 84095-9339
- Phone
- (801) 253-3158
Specialties & Taxonomy Codes
| Specialty |
|---|
| Massage Therapist |
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