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Individual

CAROL C BLACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SPECIALIST

Contact information

Practice address
705 PROFESSIONAL PLAZA DR, SUITE 3, GREENEVILLE, TN 37745-5196
(423) 638-4158
(423) 638-4158
Mailing address
705 PROFESSIONAL PLAZA DR, SUITE 3, GREENEVILLE, TN 37745-5196
(423) 638-4158
(423) 638-4158

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
515
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0184409
BLUE CROSS BLUE SHIELD TENNESSEE
TN
Enumeration date
06/19/2008
Last updated
06/19/2008
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