Individual
MRS. LYNETTE MARIE DERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4800 MEXICO RD STE 104, SAINT PETERS, MO 63376-1666
(636) 939-9540
(636) 939-9886
Mailing address
625 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-2395
(616) 483-3780
(616) 356-5001
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
0005767
FL
2251X0800X
Orthopedic Physical Therapist
Primary
19857
MA
2251X0800X
Orthopedic Physical Therapist
3614-024
WI
Other
Enumeration date
01/31/2013
Last updated
07/05/2023
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