Individual
MR. DEDRICK VAN TRUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2801 TURNPIKE RD, PORTSMOUTH, VA 23707-4630
(757) 393-8728
Mailing address
2 PEACHTREE CT, PORTSMOUTH, VA 23703-2533
(610) 349-9627
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119-009083
VA
225X00000X
Occupational Therapist
OT22058
CA
Other
Enumeration date
07/16/2021
Last updated
09/01/2021
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