MICHAEL DAVID BLACK

BOISE, ID
NPI1104488816
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: ID  OT-2071)
Enumeration Date2019-07-02
Last Update Date2019-07-02
Business Address
MICHAEL DAVID BLACK OTR/L
600 N ROBBINS RD
BOISE, ID 83702-4565
Phone number: 208-489-4444
Mailing Address
MICHAEL DAVID BLACK OTR/L
250 N GARDEN ST
BOISE, ID 83706-1832
Phone number: 307-747-6453
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