Individual
DEREK CHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
6525 2ND AVE, DETROIT, MI 48202-3006
(313) 972-4140
Mailing address
25146 HUNTER LN, FLAT ROCK, MI 48134-1843
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
5501009637
MI
2251X0800X
Orthopedic Physical Therapist
Primary
5501009637
MI
Other
Enumeration date
02/27/2018
Last updated
04/06/2021
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