Leslie Black, PT
Physical Therapist in Medford, OR. Individual provider (NPI-1).
NPI number1982183349
StatusActive
Last updated in NPPESAug 7, 2018
Details
- NPI
- 1982183349
- Entity type
- Individual (NPI-1)
- Name
- Leslie Black
- Credential
- PT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 7, 2018
- Last updated
- Aug 7, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 02834 | OR | Yes |
Practice location
1111 Crater Lake AveMedford, OR 97504-6241
Phone 541-732-5037
Mailing address
1111 Crater Lake AveMedford, OR 97504-6241
Phone 541-732-5037
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