Individual
DEREK A HATCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
222 RACOON LN, BONNERS FERRY, ID 83805-6078
(208) 610-8136
Mailing address
222 RACOON LN, BONNERS FERRY, ID 83805-6078
(208) 610-8136
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4154
ID
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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