MICHAEL T BLACK

ROSEBURG, OR
NPI1316768872
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy3747A0650X Technician, Attendant Care Provider
(Licence: OR  1922258)
Enumeration Date2024-10-17
Last Update Date2024-10-17
Business Address
MICHAEL T BLACK
317 LAD LN
ROSEBURG, OR 97471-4420
Phone number: 541-393-4138
Mailing Address
MICHAEL T BLACK
317 LAD LN
ROSEBURG, OR 97471-4420
Phone number: 541-393-4138
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