Individual
JULIA BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
141 DORMAN CENTRE DR, SPARTANBURG, SC 29301-2625
(864) 574-1985
Mailing address
2200 BERWICK DR APT 20, DUNCAN, SC 29334-8525
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12454
SC
1835G0303X
Geriatric Pharmacist
20256
NC
1835G0303X
Geriatric Pharmacist
8485
TN
Other
Enumeration date
05/07/2014
Last updated
05/07/2014
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