Individual
DERRICK WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
2701 ONTARIO RD NW, WASHINGTON, DC 20009-2144
(202) 299-9005
Mailing address
883 CLOPPER RD APT A4, GAITHERSBURG, MD 20878-4424
(518) 421-7242
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT2457
DC
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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