Individual
MISTY DAWN BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRT
Contact information
Practice address
105 CHANDLER WAY, SAINT MARYS, GA 31558-2935
(912) 674-1105
Mailing address
105 CHANDLER WAY, SAINT MARYS, GA 31558-2935
(912) 674-1105
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
—
—
Other
Enumeration date
04/26/2010
Last updated
04/26/2010
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