Individual
JENNIFER BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1450 E US HIGHWAY 36, URBANA, OH 43078-9112
(937) 653-7333
(937) 652-4574
Mailing address
1450 E US HIGHWAY 36, URBANA, OH 43078-9112
(937) 653-7333
(937) 652-4574
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18271
OH
Other
Enumeration date
05/14/2010
Last updated
05/14/2010
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