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1558025429
ERIC BLACK
SHAW AFB, SC
NPI
1558025429
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1003X Military Health Care Provider Independent Duty Medical Technicians
Enumeration Date
2021-10-27
Last Update Date
2021-10-27
Business Address
ERIC BLACK IDMT
431 MEADOWLARK ST
SHAW AFB, SC 29152-5019
Phone number: 803-895-2273
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Mailing Address
ERIC BLACK IDMT
431 MEADOWLARK ST
SHAW AFB, SC 29152-5019
Phone number: 803-895-2273
Copy
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