Organization
MARY BLACK PHYSICIANS GROUP LLC
Active
Other names
Westside Minor Car
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A SWAW (DIRECTOR)
(615) 778-8076
Entity
Organization
Contact information
Practice address
2995 REIDVILLE RD, SPARTANBURG, SC 29301-5628
(864) 587-3000
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 778-8540
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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