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1922380237
DERRICK KIRK WHITE
PROVO, UT
NPI
1922380237
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2011-09-13
Last Update Date
2011-09-13
Business Address
Mr. DERRICK KIRK WHITE
1161 E 300 N
PROVO, UT 84606-3539
Phone number: 801-852-4468
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Mailing Address
Mr. DERRICK KIRK WHITE
750 NORTH 200 WEST SUITE 300
PROVO, UT 84601
Phone number: 801-373-4760
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