Individual
CHERYL PHILIPP BLACK I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1091 KC 315, JUNCTION, TX 76849
(325) 215-1217
Mailing address
1091 KC 315, JUNCTION, TX 76849
(325) 215-1217
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
85539
TX
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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