Individual
MR. DERRICK BLANE MONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
508 SOUTH 9TH STREET, APT. # 13, LAMAR, CO 81052-3239
(719) 342-0195
Mailing address
508 SOUTH 9TH STREET, APT. # 13, LAMAR, CO 81052-3239
(719) 342-0195
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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