Individual
LIZA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 LINNIE COURT, EDGEWOOD, NM 87015
(505) 268-7838
Mailing address
8904 ARMISTICE RD NE, ALBUQUERQUE, NM 87109-5140
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2936
NM
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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