DERRICK NORTHRUP

CHUBBUCK, ID
NPI1124196340
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: ID  PT1280)
Enumeration Date2006-12-04
Last Update Date2020-03-20
Business Address
DERRICK NORTHRUP P.T.
605 TAYLOR LN
CHUBBUCK, ID 83202-5169
Phone number: 208-221-6952
Mailing Address
DERRICK NORTHRUP P.T.
605 TAYLOR LN
CHUBBUCK, ID 83202-5169
Phone number: 208-221-6952
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