Micheal Black, L.M.T. is a massage therapist in South Jordan, UT. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Micheal Black, L.M.T. NPI is 1760511422. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
10358 S REDWOOD RD
SOUTH JORDAN, UT
ZIP 84095-339
Phone: (801) 253-3158
Fax: (801) 254-5739
The CLIA number assigned to this NPI record is 46D1065409 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 3/5/2007 and was last updated on 7/8/2007.