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1336381599
DERRYCK VANCURK MOORE
PLYMOUTH, MN
NPI
1336381599
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 301674)
Enumeration Date
2009-04-01
Last Update Date
2009-04-01
Business Address
Mr. DERRYCK VANCURK MOORE LADC
12400 25TH AVE N
PLYMOUTH, MN 55441-4008
Phone number: 612-220-8645
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Mailing Address
Mr. DERRYCK VANCURK MOORE LADC
12400 25TH AVE N
PLYMOUTH, MN 55441-4008
Phone number: 612-220-8645
Copy
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