Individual
DERRICK T CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMBT
Contact information
Practice address
823 ELM STREET, SUITE 234, BUNNLEVEL, NC 28323-9244
(910) 514-3111
Mailing address
823 ELM STREET, SUITE 234, BUNNLEVEL, NC 28323-9244
(910) 514-3111
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18593
NC
Other
Enumeration date
09/20/2021
Last updated
12/03/2024
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