Individual
DERRICK ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4 GROUSE RD, DILLSBURG, PA 17019-8510
(717) 215-8914
Mailing address
4 GROUSE RD, DILLSBURG, PA 17019-8510
(717) 215-8914
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT024232
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT024232
PA STATE LICENSE TO PRACTICE
PA
Enumeration date
09/22/2015
Last updated
09/22/2015
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