Individual
MARY KATHRINE DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3020 CARBON PL STE 330, BOULDER, CO 80301-6169
(512) 573-6700
Mailing address
3020 CARBON PL STE 330, BOULDER, CO 80301-6169
(512) 573-6700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0012284
CO
Other
Enumeration date
08/08/2013
Last updated
08/08/2013
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