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Individual

DEREK ELIAS DUPRIEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4100 BARBARA LOOP SE, RIO RANCHO, NM 87124-1000
(505) 261-4782
(505) 702-8604
Mailing address
408 ALBOR CIR NE, RIO RANCHO, NM 87124-0834
(505) 261-4782

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1199
NM

Other

Enumeration date
09/04/2021
Last updated
09/04/2021
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