Individual
PHILLIP DERIFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L,M.T,
Contact information
Practice address
3344 PARTNER PL, SUITE 3, LEXINGTON, KY 40503-3574
(859) 285-2126
Mailing address
3344 PARTNER PL, SUITE 3, LEXINGTON, KY 40503-3574
(859) 285-2126
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2381
KY
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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