Individual
CHRISTINE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 ALTA VISTA ST, DUBUQUE, IA 52001-4327
(563) 588-7156
Mailing address
1450 ALTA VISTA ST, DUBUQUE, IA 52001-4327
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
075158
IA
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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