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-- DARRA BLACK -- LPTA

Individual Provider (NPI-1) Active

Physical Therapy Assistant

Provider Information

NPI Number
1821250093
Provider Type
Individual Provider (NPI-1)
Credentials
LPTA
Status
Active

Contact & Location

Address
17111 SE BUSH ST, PORTLAND, OR, 972361260
Phone
(503) 465-1031

Specialties & Taxonomies

Physical Therapy Assistant Primary License: OR #7725

All Addresses

MAILING

17111 SE BUSH ST

PORTLAND, OR, 972361260

(503) 465-1031

LOCATION

17111 SE BUSH ST

PORTLAND, OR, 972361260

(503) 465-1031