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1306218425
RYAN BLACK
BRANDON, MS
NPI
1306218425
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MS PT5552)
Enumeration Date
2015-10-28
Last Update Date
2015-10-28
Business Address
-- RYAN BLACK
355 CROSSGATES BLVD
BRANDON, MS 39042-2602
Phone number: 601-825-3192
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Mailing Address
-- RYAN BLACK
PO BOX 428
ORCHARD PARK, NY 14127-0428
Phone number:
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