Healthcare Provider Details

I. General information

NPI: 1629229943
Provider Name (Legal Business Name): BELINDA MYERS BLACK DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BELINDA L MYERS

II. Dates (important events)

Enumeration Date: 10/06/2008
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51ST MEDICAL GROUP, UNIT 2060
APO AP
96278-2060
US

IV. Provider business mailing address

51ST MEDICAL GROUP, UNIT 2060
APO AP
96278-2060
US

V. Phone/Fax

Practice location:
  • Phone: 315-784-8718
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT872058
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT8098
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: