Individual
DEREK AUTHIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
10705 TOWN SQUARE DR NE, BLAINE, MN 55449-8184
(651) 491-7176
Mailing address
10705 TOWN SQUARE DR NE, BLAINE, MN 55449-8184
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14-07317
MN
Other
Enumeration date
11/11/2014
Last updated
02/27/2015
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