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Individual
LAURA ELIZABETH BLACK
Active
Individual
LAURA ELIZABETH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
125062536
IL
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
01081976A
IN
2081P0010X
Pediatric Rehabilitation Medicine Physician
D0095134
MD
Other
Enumeration date
04/30/2013
Last updated
02/10/2023
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