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Individual

MRS. BONNIE SUE BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.A.

Contact information

Practice address
3720 QUEEN CT SW, STE. 1, CEDAR RAPIDS, IA 52404-4735
(641) 295-3310
Mailing address
3720 QUEEN CT SW, STE. 1, CEDAR RAPIDS, IA 52404-4735
(641) 295-3310

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
00305
IA

Other

Enumeration date
05/19/2006
Last updated
05/31/2012
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