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Individual

THOMAS ROBERT BLACK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ACSM RCEP

Contact information

Practice address
168 DENSLOW RD, EAST LONGMEADOW, MA 01028-3188
(413) 526-9945
Mailing address
168 DENSLOW RD, EAST LONGMEADOW, MA 01028-3188
(413) 526-9945

Taxonomy

Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary

Other

Enumeration date
08/30/2012
Last updated
08/30/2012
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