Individual
DERICK NATHANIEL BAYERSDORFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
864 US HWY 158 BUSINESS WEST, WARRENTON, NC 27589
(252) 257-2011
Mailing address
3216 SPARGER RD, DURHAM, NC 27705-1651
(954) 696-4808
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
12319
FL
224Z00000X
Occupational Therapy Assistant
Primary
8813
NC
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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