Individual
CHARLENE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
32 CHANCE DR, BARNEGAT, NJ 08005-1338
(609) 410-0638
Mailing address
32 CHANCE DR, BARNEGAT, NJ 08005-1338
(609) 410-0638
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01188500
NJ
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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