Laird Black

NPI #1326391012 in Myrtle Creek, Oregon

Provider Information

NPI Number: 1326391012
Entity Type: Individual
Name: Laird Black
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Oct 18, 2012
Last Updated: Oct 18, 2012

Practice Location

Address: 821 S MAIN ST
City: Myrtle Creek
State: Oregon
ZIP Code: 97457-9334
Phone: (541) 863-6383

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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