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1447833173
BLACK PETERSON
WEST COLUMBIA, SC
NPI
1447833173
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084N0600X Psychiatry & Neurology, Clinical Neurophysiology
(Licence: SC 4700)
Enumeration Date
2021-04-30
Last Update Date
2021-04-30
Business Address
BLACK PETERSON CNIM
1304 SUNSET BLVD # 203
WEST COLUMBIA, SC 29169-5914
Phone number: 888-851-3677
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Mailing Address
BLACK PETERSON CNIM
1304 SUNSET BLVD # 203
WEST COLUMBIA, SC 29169-5914
Phone number: 888-851-3677
Copy
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