NPI Index

MR. DEMONTERRYO BLACK SR., DO

Home Health Aide

Active Individual
NPI: 1194392910

Practice Address

6652 N TOWNE RD APT 121
Windsor, WI 53598

Phone: (608) 906-4343

Specialties

Specialty Code Primary License
Home Health Aide 374U00000X Yes -

Frequently Asked Questions

NPI 1194392910 is the National Provider Identifier for MR. DEMONTERRYO BLACK SR., DO, a Home Health Aide provider located in Windsor, WI. This NPI was enumerated on June 9, 2021.
MR. DEMONTERRYO BLACK SR., DO practices at 6652 N TOWNE RD APT 121, Windsor, WI 53598.

Quick Facts

NPI
1194392910
Type
Individual
Enumerated
Jun 9, 2021
Last Updated
Jun 17, 2021

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