Individual
AUSTIN JOEL BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
8140 TOWNSHIP LINE RD, INDIANAPOLIS, IN 46260-5824
(317) 875-9700
Mailing address
3724 KNICKERBOCKER PL APT 1D, INDIANAPOLIS, IN 46240-2186
(317) 294-1584
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006408A
IN
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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