Individual
MS. STACY RENEE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,PT
Contact information
Practice address
9108 LOS ARBOLES AVE NE, ALBUQUERQUE, NM 87112-1267
(505) 508-8589
(505) 294-4552
Mailing address
9108 LOS ARBOLES AVE NE, ALBUQUERQUE, NM 87112-1267
(505) 508-8589
(505) 294-4552
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3429
NM
Other
Enumeration date
09/24/2007
Last updated
09/01/2015
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