Individual
DERICK RICHARD WHISMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6682 E TYGARTS RD, GREENUP, KY 41144-6544
(606) 585-2471
Mailing address
6682 E TYGARTS RD, GREENUP, KY 41144-6544
(606) 585-2471
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
OH
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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