CRYSTALENE BLACK

TUBA CITY, AZ
NPI1316214893
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy376K00000X Nurse's Aide
(Licence: NM  NM0070120209E)
Enumeration Date2011-11-28
Last Update Date2011-11-28
Business Address
-- CRYSTALENE BLACK CNA
167 NORTH MAIN STREET
TUBA CITY, AZ 86045-0600
Phone number: 928-283-2501
Mailing Address
-- CRYSTALENE BLACK CNA
PO BOX 600
TUBA CITY, AZ 86045-0600
Phone number: 928-283-2501
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