Individual
STEFFANI BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5601 BRIDGE ST STE 500, FORT WORTH, TX 76112-2352
(682) 990-5600
Mailing address
5601 BRIDGE ST STE 500, FORT WORTH, TX 76112-2352
(682) 990-5600
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2045185
TX
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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