Individual
DERICK R HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1321 S PATRICK DR, PATRICK AFB, FL 32925-3606
(321) 494-8245
Mailing address
17211 32ND LN N, LOXAHATCHEE, FL 33470-3610
(202) 253-7557
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/23/2009
Last updated
07/23/2009
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