Individual
DERRICK MATHIS
Active
Individual
DERRICK MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
172V00000X
Community Health Worker
Primary
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
01/13/2012
Last updated
01/13/2012
Update your record
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