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Individual

KATELYN BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10455 LINCOLN HWY, EVERETT, PA 15537-7046
(814) 623-6161
Mailing address
101 CARSON HEIGHTS DR, DUNCANSVILLE, PA 16635-6547

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA057785
PA

Other

Enumeration date
10/27/2015
Last updated
03/25/2021
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