Individual
ALEX KENDRICK BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
150 JAMERSON CENTER (0502) 21 BEAMER WAY, BLACKSBURG, VA 24061-0001
(540) 231-6410
Mailing address
834 PATRICK HENRY DR, BLACKSBURG, VA 24060-3141
(513) 728-1141
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002567
VA
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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