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Individual

MARY MEGAN BLACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
1000 HIGHWAY 78 W, JASPER, AL 35501-3655
(205) 471-5713
Mailing address
3967 ASPEN ST, NORTHPORT, AL 35475-4634
(205) 792-5974

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH10809
AL

Other

Enumeration date
05/17/2022
Last updated
05/17/2022
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