Individual
MR. DOUGLAS CHARLES BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.P.T.
Contact information
Practice address
700 FLAGWELL CIR., SUITE 0, CLINTON, SC 29325
(864) 833-2368
Mailing address
415 MUSGROVE ST, CLINTON, SC 29325-1720
(864) 923-0986
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
902
SC
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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