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Organization

MARY BLACK PHYSICIANS GROUP LLC

Active
Other names
Ortho Upstate
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL A SWAW (DIRECTOR)
(615) 778-8076
Entity
Organization

Contact information

Practice address
722 HYATT ST, SUITE D, GAFFNEY, SC 29341-2643
(864) 488-3336
(864) 488-4439
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 778-8540
(615) 628-6877

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
12/31/2015
Last updated
12/31/2015
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