Individual
MS. REBECCA A. BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-4107
Mailing address
1 MEDICAL PARK BLVD, BRISTOL, TN 37620-7430
(423) 844-4107
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
830
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3652789
—
TN
01
—
85539
BLUE CROSS
TN
Enumeration date
05/16/2006
Last updated
07/23/2007
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