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General NPI Number Information
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NPI Number | 1427361468
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Entity Type | Individual
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Provider Name | CHRISTINE BLACK PT
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Gender | Female
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Dates
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Enumeration Date | 07/20/2010
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 527 POCKET RD
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City | HURT
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State | VA
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Zip | 24563-2023
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Country | US
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Telephone | 434-324-9750
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Fax | 434-324-9796
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Provider Business Mailing Address
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Address Line | 1948 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1009
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Country | US
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Telephone | 434-845-9053
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Fax | 434-528-2788
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305206549
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License Number State | VA
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