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1194392910
DEMONTERRYO L BLACK
WINDSOR, WI
NPI
1194392910
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Other Name
SHELBY J BREMER
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
374U00000X Home Health Aide
Enumeration Date
2021-06-09
Last Update Date
2021-06-17
Business Address
Mr. DEMONTERRYO L BLACK do
6652 N TOWNE RD APT 121
WINDSOR, WI 53598-9130
Phone number: 608-906-4343
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Mailing Address
Mr. DEMONTERRYO L BLACK do
1173 OKEEFFE AVE
SUN PRAIRIE, WI 53590-4236
Phone number: 608-906-4343
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