DEREK JOHN BLACK

LOGAN, UT
NPI1679231237
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2021-12-01
Last Update Date2021-12-01
Business Address
DEREK JOHN BLACK
475 W 1465 N APT 103
LOGAN, UT 84341-6619
Phone number: 435-851-3813
Mailing Address
DEREK JOHN BLACK
475 W 1465 N APT 103
LOGAN, UT 84341-6619
Phone number: 435-851-3873
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