Individual
DR. DERIK NELSON BALTICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1086 RIVER HWY, SUITE D, MOORESVILLE, NC 28117-9147
(704) 799-1999
(704) 663-8225
Mailing address
206 JOE V KNOX AVENUE, SUITE C, MOORESVILLE, NC 28117
(704) 799-1999
(704) 663-8225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3047
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89085MF
—
NC
Enumeration date
11/09/2006
Last updated
02/04/2010
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