Individual
DEREK HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 SIXTH ST STE 200, TRAVERSE CITY, MI 49684-2369
(231) 935-5800
(231) 935-5799
Mailing address
1200 SIXTH ST STE 200, TRAVERSE CITY, MI 49684-2369
(231) 935-5800
(231) 935-5799
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601009719
MI
Other
Enumeration date
12/09/2019
Last updated
03/15/2021
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