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Individual
DR. DERRICK BLAINE HINES
Active
Individual
DR. DERRICK BLAINE HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
08100
LA
225100000X
Physical Therapist
PTH6216
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102I656395
MEDICARE PTAN
LA
Enumeration date
08/01/2011
Last updated
02/26/2014
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