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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JEFFREY DERTHICK

Active Sole Proprietor

JEFFREY DERTHICK is a Behavioral Health, Residential healthcare provider located in MANTUA, Ohio. NPI 1073312591 is currently active in the NPPES registry. Verify at CMS.

Behavioral Health, Residential · MANTUA, OH

Registration Details

NPI Number
1073312591
Provider Type
Individual
Gender
Male
NPI Issued
Mar 8, 2025 (1.4802948728128 yrs)
Last Updated
Mar 8, 2025
Sole Proprietor
Yes

Practice Information

Address
6470 STREETER RD
MANTUA, OH, 442559729
Browse OH providers · Browse ZIP 44255
Phone
3302211046
Primary Specialty
Behavioral Health, Residential
251C00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.