Individual
DARRIN W DEREU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
N CAROLINA STATE UNIVERSITY, 2500 WARREN CARROL DRIVE, BOX 8502, RALEIGH, NC 27695-8502
(919) 513-7295
Mailing address
3404 SOSA RD, RALEIGH, NC 27610-4097
(919) 513-7295
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0805
NC
Other
Enumeration date
07/30/2006
Last updated
07/08/2007
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