Individual
LANDON DERU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC-L
Contact information
Practice address
3730 BRINKER AVE, OGDEN, UT 84403-2019
(801) 928-3213
Mailing address
3730 BRINKER AVE, OGDEN, UT 84403-2019
(801) 928-3213
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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