Individual
MARK TERRENCE DERREVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
LONE TREE MEDICAL CENTER, 9548 PARK MEADOWS DRIVE, LONE TREE, CO 80124
(720) 281-8114
(720) 553-0901
Mailing address
LONE TREE MEDICAL CENTER, 9548 PARK MEADOWS DRIVE, LONE TREE, CO 80124
(720) 281-8114
(720) 553-0901
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0001549
CO
225XH1200X
Hand Occupational Therapist
OT.0001549
CO
225XH1200X
Hand Occupational Therapist
—
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Other
Enumeration date
11/25/2020
Last updated
12/08/2020
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