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Individual

GEORGIA BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
901 MEDICAL CENTER DR STE 100, DECATUR, TX 76234-3874
(940) 290-0273
Mailing address
223 HICKORY ST, PARADISE, TX 76073-2764

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary

Other

Enumeration date
06/04/2026
Last updated
06/04/2026
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