Individual
DR. EDDIE J BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
510 N BROADWAY ST, CLEVELAND, OK 74020-2206
(918) 358-3509
(918) 358-3026
Mailing address
510 N BROADWAY ST, CLEVELAND, OK 74020-2206
(918) 358-3509
(918) 358-3026
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
1611
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1611
TYPE I
OK
Enumeration date
03/19/2007
Last updated
07/08/2007
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