Individual
MR. ALAN D BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 JOEL DRIVE, BACH-YEC, FT CAMPBELL, KY 42223
(270) 798-8258
Mailing address
650 JOEL DRIVE, BACH-YEC, FT CAMPBELL, KY 42223
(270) 798-8258
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2040679
KY
Other
Enumeration date
01/09/2009
Last updated
01/09/2009
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