Black, Marshall R

Black, Marshall R is an sole proprietor health care provider with primary practice located at 823 16Th Ave , Lewiston ID 83501-3733. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist is his primary health care specialty. Black, Marshall R can be contacted via phone (208) 798-0200.

Contact Information

Primary practice address
823 16Th Ave Lewiston ID 83501-3733
Phone: (208) 798-0200
Fax: (208) 798-0201
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist 224P00000X

Profile Details

NPI number 1154357242
LBN Legal business name Black, Marshall R
Credentials CPO
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2006
Last updated Nov 2nd, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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