Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DEMONTERRYO L BLACK SR., DO
ActiveMR. DEMONTERRYO L BLACK SR., DO is a Home Health Aide healthcare provider located in WINDSOR, Wisconsin. NPI 1194392910 is currently active in the NPPES registry. Verify at CMS.
Home Health Aide · WINDSOR, WI
Registration Details
- NPI Number
- 1194392910
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 9, 2021 (5.2105168383911 yrs)
- Last Updated
- Jun 17, 2021
Practice Information
- Address
-
6652 N TOWNE RD APT 121WINDSOR, WI, 535989130Browse WI providers · Browse ZIP 53598
- Phone
- 6089064343
- Primary Specialty
-
Home Health Aide
374U00000X
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.