MICHAEL BLACK

LEON, IA
NPI1598439713
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner Family
(Licence: IA  A164712)
Enumeration Date2021-08-02
Last Update Date2022-05-13
Business Address
MICHAEL BLACK
302 NE 14TH ST
LEON, IA 50144-1206
Phone number: 641-446-2383
Mailing Address
MICHAEL BLACK
11921 W STATE HIGHWAY YY
EAGLEVILLE, MO 64442-9193
Phone number: 660-373-2134