Individual
KYLE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3616 E MAIN ST, WHITEHALL, OH 43213-2913
(888) 586-7168
Mailing address
5668 QUAIL RUN DR, GROVE CITY, OH 43123-8505
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.007243
OH
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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