-- MARSHALL R BLACK -- CPO
Individual Provider (NPI-1)
Active
Provider Information
- NPI Number
1154357242- Provider Type
- Individual Provider (NPI-1)
- Credentials
- CPO
- Status
- Active
Contact & Location
- Address
- 823 16TH AVE, LEWISTON, ID, 835013733
- Phone
- (208) 798-0200
- Fax
- (208) 798-0201
Specialties & Taxonomies
Unknown
Primary
Prosthetist