Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARSHALL R BLACK, CPO
Active Sole ProprietorMARSHALL R BLACK, CPO is a Orthotist healthcare provider located in LEWISTON, Idaho. NPI 1154357242 is currently active in the NPPES registry. Verify at CMS.
Orthotist · LEWISTON, ID
Registration Details
- NPI Number
- 1154357242
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 23, 2006 (20.111206354867 yrs)
- Last Updated
- Nov 2, 2007
- Sole Proprietor
- Yes
Practice Information
- Address
-
823 16TH AVELEWISTON, ID, 835013733Browse ID providers · Browse ZIP 83501
- Phone
- 2087980200
- Fax
- 2087980201
- Primary Specialty
-
Orthotist
222Z00000X
- Additional Specialty
- Pulmonary Function Technologist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.