Individual
MRS. ANGELA M DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
800 SCHOOL ST, CARROLLTON, IL 62016-1436
(217) 942-6946
Mailing address
402 MINARD ST, JERSEYVILLE, IL 62052-2630
(575) 312-4439
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070018073
IL
225100000X
Physical Therapist
NM2654
NM
Other
Enumeration date
03/27/2006
Last updated
08/01/2012
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