Individual
MR. DEREK YOUNGBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164791992
ART MEDICAL
—
Enumeration date
06/09/2017
Last updated
06/09/2017
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