Individual
ASHLEY BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-8780
(910) 321-6250
Mailing address
PO BOX 40908, FAYETTEVILLE, NC 28309-0908
(910) 615-6448
(910) 615-5070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03266
NC
Other
Enumeration date
02/03/2012
Last updated
04/19/2013
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