Black, Rebecca A.

Black, Rebecca A. is an individual health care provider with primary practice located at 1 Medical Park Blvd , Bristol TN 37620-7430. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Black, Rebecca A. can be contacted via phone (423) 844-4107.

Contact Information

Primary practice address
1 Medical Park Blvd Bristol TN 37620-7430
Phone: (423) 844-4107
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 830 Tennessee

Profile Details

NPI number 1720030257
LBN Legal business name Black, Rebecca A.
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Jul 23rd, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1720030257 NPPES
Tennessee MEDICAID 3652789
Tennessee Other 85539

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