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1790208544
DERRICK BRENT FREEMAN
MODESTO, CA
NPI
1790208544
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA 54664)
Enumeration Date
2017-07-24
Last Update Date
2017-07-24
Business Address
DERRICK BRENT FREEMAN
1441 FLORIDA AVE
MODESTO, CA 95350-4404
Phone number: 209-578-1211
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Mailing Address
DERRICK BRENT FREEMAN
2020 LARRY PL
LIVERMORE, CA 94550-6469
Phone number: 925-784-3453
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