Individual
DEREK ALEXANDER DELUCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24645
MA
2251X0800X
Orthopedic Physical Therapist
5501018825
MI
Other
Enumeration date
08/31/2018
Last updated
11/18/2019
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