Individual
BONNIE MARIE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 LILLIAN LANE, LYNCHBURG, VA 24502-4379
(434) 316-0254
Mailing address
201 LILLIAN LANE, LYNCHBURG, VA 24502-4379
(434) 316-0254
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306601592
VA
Other
Enumeration date
07/18/2015
Last updated
07/18/2015
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