Individual
MR. KERRY DEERING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1841 E MORROW AVE, KINGMAN, AZ 86409-3026
(928) 753-4263
(928) 753-1173
Mailing address
PO BOX 3278, KINGMAN, AZ 86402-3278
(928) 753-4263
(928) 753-1173
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0104
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
547096001
DMERC
AZ
05
—
77094
—
AZ
01
—
AZ0292050
BCBS AZ
AZ
Enumeration date
09/14/2006
Last updated
12/27/2013
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