NPI 1053301887

Robert E Black, ATC

Practitioner Athletic Trainer Bloomington, IN

Practice location

Address: 1001 E 17th St, Bloomington, IN 47408-1590
Phone: (812) 856-2225
Fax: (812) 855-1810
Mailing address: 1207 W Wintersweet CT, Bloomington, IN 47404-1827

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 36000062A (IN)

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Registry record

NPI: 1053301887
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Oct 2005
Record last updated: 13 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.