Individual
LINDA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
700 HIGH ST, WILLIAMSPORT, PA 17701-3100
(570) 323-9104
Mailing address
230 BLOOMINGROVE ROAD ANX, WILLIAMSPORT, PA 17701-9426
(570) 323-9104
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI003965
PA
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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