Individual
MR. JAMES EDWIN BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
302 CEDAR RIDGE RD, SISSONVILLE, WV 25320-9502
(304) 984-0046
(304) 984-3875
Mailing address
PO BOX 4065, CHARLESTON, WV 25364-4065
(304) 553-2502
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P.T.2477
WV
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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