Individual
MR. DEREK DEROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
680 PLEASANT VIEW RIDGE RD, CHINA, ME 04358-4420
(207) 620-6544
Mailing address
680 PLEASANT VIEW RIDGE RD, CHINA, ME 04358-4420
(207) 620-6544
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4186
CT
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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