DERICK BLACKSON

LAS VEGAS, NV
NPI1659785806
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225400000X Rehabilitation Practitioner
Enumeration Date2014-06-16
Last Update Date2014-06-16
Business Address
-- DERICK BLACKSON
3674 N RANCHO DR 101
LAS VEGAS, NV 89130-3110
Phone number: 702-396-2988
Mailing Address
-- DERICK BLACKSON
1034 10TH ST
OAKLAND, CA 94607-2720
Phone number: 702-396-2988
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