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Micheal Black, L.M.T
NPI 1760511422 · on the registry since 2007 · sole proprietor
Practice
- Address
- 10358 S Redwood Rd
South Jordan, UT 84095 - Phone
- (801) 253-3158
- Fax
- (801) 254-5739
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 225700000X
225700000X
- Licence states on file
- UT
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
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