Individual
MR. MATTHEW DAVID BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
H.I.S.
Contact information
Practice address
3656 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7573
(208) 529-4969
Mailing address
3656 WASHINGTON PKWY, IDAHO FALLS, ID 83404-7573
(208) 529-4969
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA3634
ID
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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