Individual
JEFF BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6641 W AMARILLO BLVD, AMARILLO, TX 79106-1755
(806) 352-8800
Mailing address
6641 W AMARILLO BLVD, AMARILLO, TX 79106-1755
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209094
TX
Other
Enumeration date
05/08/2019
Last updated
05/08/2019
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