TIM BLACK

EUGENE, OR
NPI1104382324
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
(Licence:   professionallicense)
Enumeration Date2019-02-12
Last Update Date2022-02-08
Business Address
TIM BLACK
2222 COBURG RD STE 100
EUGENE, OR 97401-4988
Phone number: 458-210-2984
Mailing Address
TIM BLACK
3587 HEATHROW WAY
MEDFORD, OR 97504-4004
Phone number: 541-858-8170
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