Individual
ANGELINA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3151 S 400 E APT 4, SOUTH SALT LAKE, UT 84115-4076
(801) 897-2528
Mailing address
3151 S 400 E APT 4, SOUTH SALT LAKE, UT 84115-4076
(801) 897-2528
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8695543-4701
UT
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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