Individual
RODNEY B BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3760 LAVISTA RD, SUITE 102, TUCKER, GA 30084-5615
(404) 248-0415
(404) 248-0422
Mailing address
100 AZALEA DR, FAIRBURN, GA 30213-1705
(404) 248-0415
(404) 248-0422
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0652
GA
Other
Enumeration date
12/27/2006
Last updated
07/08/2007
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