MATTHEW BLACK

FORT BENNING, GA
NPI1093594319
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225X00000X Occupational Therapist
(Licence: GA  OT009562)
Enumeration Date2023-09-26
Last Update Date2025-06-06
Business Address
MATTHEW BLACK OTD
5241 23RD INFANTRY REGIMENT ST BLDG 3410
FORT BENNING, GA 31905-5922
Phone number: 541-226-7995
Mailing Address
MATTHEW BLACK OTD
6600 VAN AALST BLVD
FORT BENNING, GA 31905-2102
Phone number: 541-226-7995