Individual
DERITH FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
414 MAIN ST, WAKEFIELD, MA 01880-3018
(781) 245-0055
Mailing address
10 FREDRICKSON RD, BILLERICA, MA 01821-5313
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
21572
MA
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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