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1366166043
DEMITRIA MARIE DERRICO
BOSTON, MA
NPI
1366166043
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MA 3713)
Enumeration Date
2022-09-27
Last Update Date
2022-09-27
Business Address
DEMITRIA MARIE DERRICO
285 BABCOCK ST
BOSTON, MA 02215-1003
Phone number: 617-353-2746
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Mailing Address
DEMITRIA MARIE DERRICO
28 LITCHFIELD ST APT 3
BRIGHTON, MA 02135-1499
Phone number: 304-685-5542
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