Individual
JOHN JAMES BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
403 E FLOURNOY LUCAS RD, SHREVEPORT, LA 71115-3906
(318) 213-3500
Mailing address
PO BOX 579, SUMMIT, MS 39666-0579
(601) 276-3900
(601) 276-3938
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02792F
LA
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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