Matthew Black

NPI 1639941925 · on the registry since 2023

Practice

Address: 331 W 2700 S
South Salt Lake, UT 84115
Phone: (801) 678-3317
Organisation at this address: St Anthony House Treatment Program
Saint Anthony House Treatment Programs
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 19

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: UT
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2024-05-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah