Individual
DERRICK HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1365 E PRKS HWY, SUITE 100, WASILLA, AK 99654
(907) 357-6445
Mailing address
1365 E PRKS HWY, SUITE 100, WASILLA, AK 99654
(907) 357-6445
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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