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1972800514
DERICK LEE TIBBETTS
WICHITA, KS
NPI
1972800514
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1003X Military Health Care Provider, Independent Duty Medical Technicians
Enumeration Date
2011-02-17
Last Update Date
2011-02-17
Business Address
Mr. DERICK LEE TIBBETTS IDMT
638 S WHITTIER ST
WICHITA, KS 67207-2222
Phone number: 316-841-3810
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Mailing Address
Mr. DERICK LEE TIBBETTS IDMT
638 S WHITTIER ST
WICHITA, KS 67207-2222
Phone number: 316-841-3810
Copy
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