Individual
PAIGE BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1750 HIGHWAY 160 W, FORT MILL, SC 29708-8009
(803) 396-0450
Mailing address
1750 HIGHWAY 160 W, FORT MILL, SC 29708-8009
(803) 396-0450
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
35625
SC
Other
Enumeration date
07/11/2014
Last updated
09/04/2016
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