Individual
MERRITT R BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3205 HURLEY WAY, SACRAMENTO, CA 95864-3853
(915) 648-5677
(916) 485-2653
Mailing address
3205 HURLEY WAY, SACRAMENTO, CA 95864-3853
(915) 648-5677
(916) 485-2653
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
3207
CA
Other
Enumeration date
10/01/2012
Last updated
10/01/2012
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