Individual
KEVIN HEATH BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T., D.P.T.
Contact information
Practice address
8201 ATLEE RD, SUITE D, MECHANICSVILLE, VA 23116-1815
(804) 569-1787
(804) 569-9787
Mailing address
8201 ATLEE RD., SUITE D, MECHANICSVILLE, VA 23116-1815
(804) 569-1787
(804) 569-9787
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305206040
VA
Other
Enumeration date
07/23/2009
Last updated
07/23/2009
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