Individual
MRS. LORI ANN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
407 4TH ST, NEWPORT, TN 37821-3755
(423) 625-8446
(423) 623-1899
Mailing address
1103 VILLAGE DRIVE, SEVIERVILLE, TN 37862
(865) 908-3261
(865) 908-7043
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5755
TN
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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