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Individual

DEMITRIA MARIE DERRICO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
285 BABCOCK ST, BOSTON, MA 02215-1003
(617) 353-2746
Mailing address
28 LITCHFIELD ST APT 3, BRIGHTON, MA 02135-1499
(304) 685-5542

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3713
MA

Other

Enumeration date
09/27/2022
Last updated
09/27/2022
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