Matthew Black, H.I.S

NPI 1639718745 · on the registry since 2020 · sole proprietor

Practice

Address: 3656 Washington Pkwy
Idaho Falls, ID 83404
Phone: (208) 529-4969
Organisation at this address: Elison Dental Center
My Hearing Centers, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 3

Registry record

Primary taxonomy: 237700000X
237700000X
Licence states on file: ID
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2020-01-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho