Derek John Black

NPI #1679231237 in Logan, Utah

Provider Information

NPI Number
1679231237
Entity Type
Individual
Name
Derek John Black
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Case Manager/Care Coordinator
Enumeration Date
Dec 1, 2021
Last Updated
Dec 1, 2021

Practice Location

Address
475 W 1465 N APT 103
City
Logan
State
Utah
ZIP Code
84341-6619
Phone
(435) 851-3813

Specialties & Taxonomy Codes

Specialty
Case Manager/Care Coordinator

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