Individual
DANIELLE DARLENE DERETCHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1508 N THORNTON AVE STE 106, DALTON, GA 30720
(706) 226-0816
(706) 226-9584
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-2564
(423) 238-7217
(423) 362-8684
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003421
GA
Other
Enumeration date
06/27/2018
Last updated
07/31/2018
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