Individual
TROY BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23900 CHAGRIN BLVD, BEACHWOOD, OH 44122-5511
(216) 464-1000
Mailing address
PO BOX 6243, WHEELING, WV 26003-0722
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG03210086
OH
363LG0600X
Gerontology Nurse Practitioner
APRN.CNP.0028609
OH
Other
Enumeration date
04/14/2021
Last updated
01/27/2022
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