MARY BLACK PHYSICIANS GROUP LLC

SPARTANBURG, SC
NPI1427276203
Entity TypeOrganization
Authorized ContactDONNA L MATTSON
Senior Credentialing Coordinator
214-473-7043
Organization Subpart ?No
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
Enumeration Date2007-04-24
Last Update Date2009-06-12
Business Address
MARY BLACK PHYSICIANS GROUP LLC
170 CAMELOT DR
SPARTANBURG, SC 29301-2650
Phone number: 864-576-1614
Mailing Address
MARY BLACK PHYSICIANS GROUP LLC
PO BOX 277827
ATLANTA, GA 30384-7827
Phone number: 864-576-1614