Individual
DR. GAVIN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
250 10TH ST NE APT 1403, ATLANTA, GA 30309-3713
(704) 891-4441
Mailing address
250 10TH ST NE APT 1403, ATLANTA, GA 30309-3713
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010678
GA
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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