Individual
LATONYA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
16170 KINGSPORT ROAD, ORLAND PARK, IL 60467
(708) 349-6544
Mailing address
2117 PORTE DE LEAU CT APT 301, HIGHLAND, IN 46322
(708) 349-6544
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004482
IN
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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