Individual
ROBERT G BLACK SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3550 HARRISON BLVD STE D, OGDEN, UT 84403-2081
(801) 476-4141
(801) 476-2097
Mailing address
3550 HARRISON BLVD STE D, OGDEN, UT 84403-2081
(801) 476-4141
(801) 476-2097
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
343568-2401
UT
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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