Individual
MARK D BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
317 MAIN ST, EAGLE BUTTE, SD 57625
(605) 964-7724
(605) 364-1340
Mailing address
317 MAIN ST, EAGLE BUTTE, SD 57625
(605) 964-7724
(605) 364-1340
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6007
ID
Other
Enumeration date
02/26/2007
Last updated
07/08/2007
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