Black, Bryan
Black, Bryan is an individual health care provider with primary practice located at 3946 Ice Way Fort Wayne , Fort Wayne IN 46808. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Black, Bryan can be contacted via phone (517) 425-4996.Contact Information
Primary practice address
3946 Ice Way Fort Wayne
Fort Wayne IN 46808
Phone: (517) 425-4996
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 36002703A | Indiana |
Profile Details
| NPI number | 1407358377 |
|---|---|
| LBN Legal business name | Black, Bryan |
| Credentials | MAT, LAT, ATC, CKTP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 6th, 2018 |
| Last updated | Mar 6th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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