Individual
JAN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PT
Contact information
Practice address
90 ALBION VILLAGE WAY, SANDY, UT 84070-4013
(801) 619-3670
(801) 619-3679
Mailing address
90 ALBION VILLAGE WAY, SANDY, UT 84070-4013
(801) 619-3670
(801) 619-3679
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
120890-2401
UT
Other
Enumeration date
04/28/2006
Last updated
04/13/2020
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