Individual
DEREK CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7735 GRANDWIND DR, LORTON, VA 22079-4738
(936) 391-6435
Mailing address
7735 GRANDWIND DR, LORTON, VA 22079-4738
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/27/2015
Last updated
12/15/2015
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