Individual
DR. JANICE GWEN DERRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1305 MUMFORD LN, LEXINGTON, KY 40513-1743
(859) 224-2309
(859) 224-0563
Mailing address
1305 MUMFORD LN, LEXINGTON, KY 40513-1743
(859) 224-2309
(859) 224-0563
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003876
KY
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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