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Individual

MS. SANDRA RA'CHELLE BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
8217 AVENUE U APT 4208, LUBBOCK, TX 79423-3411
(619) 417-3179
Mailing address
8217 AVENUE U APT 4208, LUBBOCK, TX 79423-3411
(619) 417-3179

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
CA

Other

Enumeration date
04/11/2007
Last updated
07/08/2007
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