Individual
MARCUS LINCOLN DERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 UNIVERSITY AVE, SUITE 2B, FAIRBANKS, AK 99709
(907) 371-2240
Mailing address
600 UNIVERSITY AVE, SUITE 2B, FAIRBANKS, AK 99709
(907) 371-2240
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
04/07/2022
Last updated
07/17/2024
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