Individual
MS. KEISHA L BLACK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RKT
Contact information
Practice address
1603 SPRINGRIDGE RD, GAUTIER, MS 39553-3123
(228) 497-8189
Mailing address
1603 SPRINGRIDGE RD, GAUTIER, MS 39553-3123
(228) 497-8189
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
—
—
Other
Enumeration date
05/20/2006
Last updated
07/08/2007
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