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1003151028
CASEY R. BLACK
STOCKBRIDGE, GA
NPI
1003151028
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: GA RN146749)
Enumeration Date
2012-12-03
Last Update Date
2017-05-10
Business Address
-- CASEY R. BLACK NP
125 EAGLE SPRING DR
STOCKBRIDGE, GA 30281-6328
Phone number: 770-213-3366
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Mailing Address
-- CASEY R. BLACK NP
125 EAGLE SPRING DR
STOCKBRIDGE, GA 30281-6328
Phone number: 770-213-3366
Copy
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