Individual
CRISTIAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
12301 EVA ST, MATTHEWS, NC 28105-3526
(704) 840-8322
Mailing address
12301 EVA ST, MATTHEWS, NC 28105-3526
(704) 840-8322
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3803
NC
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
05/15/2019
Last updated
07/19/2022
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