Organization
ROCKY MOUNTAIN HUMAN PERFORMANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN ALLEN BLACK PHD, PT (DIRECTOR)
(413) 739-2700
Entity
Organization
Contact information
Practice address
1111 ELM ST, SUITE 16, WEST SPRINGFIELD, MA 01089-1540
(413) 739-2700
Mailing address
1111 ELM ST, SUITE 16, WEST SPRINGFIELD, MA 01089-1540
(413) 739-2700
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
6649
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3343586
AETNA
MA
01
—
Y61403
BLUE CROSS
MA
Enumeration date
05/17/2007
Last updated
08/22/2020
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