Individual
MARY E DERCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2865 N REYNOLDS RD, STE. 110, TOLEDO, OH 43615-2068
(419) 578-7530
Mailing address
6602 DORR ST APT 202, TOLEDO, OH 43615-4238
(419) 578-7530
(419) 539-0288
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.002401
OH
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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