Individual
TAYLOR BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, C.S.C.S.
Contact information
Practice address
1145 BRIGHTON AVE, PORTLAND, ME 04102-1025
(207) 541-6500
Mailing address
49 TECHNOLOGY DR UNIT 51, BEDFORD, NH 03110-6970
(760) 695-2899
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6035
ME
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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