Individual
DEREK LANDRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
4427 VENOY RD, WAYNE, MI 48184-1871
(734) 729-4436
Mailing address
49222 GEDDES RD, CANTON, MI 48188-2204
(248) 330-7163
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008526
MI
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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