MR. Demonterryo L Black SR., DO

NPI #1194392910 in Windsor, Wisconsin

Provider Information

NPI Number: 1194392910
Entity Type: Individual
Name: MR. Demonterryo L Black SR., DO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Home Health Aide
Credential: DO
Enumeration Date: Jun 9, 2021
Last Updated: Jun 17, 2021

Practice Location

Address: 6652 N TOWNE RD APT 121
City: Windsor
State: Wisconsin
ZIP Code: 53598-9130
Phone: (608) 906-4343

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health Aide	374U00000X	Primary

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