Organization
MARY BLACK PHYSICIANS GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
5470 N MAIN ST, COWPENS, SC 29330-9705
(864) 463-3286
(864) 463-3286
Mailing address
5470 N MAIN ST, COWPENS, SC 29330-9705
(864) 463-3286
(864) 463-3286
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/20/2007
Last updated
07/02/2009
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