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1679696074
SUSAN GAIL BLACK
GERMANTOWN, TN
NPI
1679696074
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: TN 1461)
Enumeration Date
2007-04-09
Last Update Date
2007-07-08
Business Address
-- SUSAN GAIL BLACK OTR
2120 EXETER RD
GERMANTOWN, TN 38138-3922
Phone number: 901-624-8677
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Mailing Address
-- SUSAN GAIL BLACK OTR
1876 SNOWDEN AVE REAR APT.
MEMPHIS, TN 38107-5119
Phone number: 901-274-3353
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