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1356009971
DERRICK MARTINEZ
DETROIT, MI
NPI
1356009971
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-12-01
Last Update Date
2021-12-01
Business Address
DERRICK MARTINEZ
2995 E GRAND BLVD
DETROIT, MI 48202-3133
Phone number: 512-552-5170
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Mailing Address
DERRICK MARTINEZ
275 LAKE VILLAGE DR APT 306
ANN ARBOR, MI 48103-6542
Phone number: 512-552-5170
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