Individual
CARLY JO BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2006 AVENUE F, SCOTTSBLUFF, NE 69361-4012
(308) 641-3075
Mailing address
2006 AVENUE F, SCOTTSBLUFF, NE 69361-4012
(308) 641-3075
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/24/2025
Last updated
04/24/2025
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