Organization
CENTER FOR TEAM HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHAN J BLACK D.C. (OWNER)
(435) 649-1542
Entity
Organization
Contact information
Practice address
1901 PROSPECTOR AVE STE 10, PARK CITY, UT 84060-7207
(435) 649-1542
(435) 658-4909
Mailing address
1901 PROSPECTOR AVE STE 10, PARK CITY, UT 84060-7550
(435) 649-1542
(435) 658-4909
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
221669991202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
569743626001
—
UT
Enumeration date
01/24/2008
Last updated
07/08/2019
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