DEMONTERRYO L BLACK

WINDSOR, WI
NPI1194392910
Other NameSHELBY J BREMER
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy374U00000X Home Health Aide
Enumeration Date2021-06-09
Last Update Date2021-06-17
Business Address
Mr. DEMONTERRYO L BLACK do
6652 N TOWNE RD APT 121
WINDSOR, WI 53598-9130
Phone number: 608-906-4343
Mailing Address
Mr. DEMONTERRYO L BLACK do
1173 OKEEFFE AVE
SUN PRAIRIE, WI 53590-4236
Phone number: 608-906-4343