Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DERRICK D DITZLER, LMT
Active Sole ProprietorMR. DERRICK D DITZLER, LMT is a Massage Therapist healthcare provider located in CORTLAND, Illinois. NPI 1174806590 is currently active in the NPPES registry. Verify at CMS.
Massage Therapist · CORTLAND, IL
Registration Details
- NPI Number
- 1174806590
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 21, 2011 (14.874179494883 yrs)
- Last Updated
- Sep 21, 2011
- License
-
227012825 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
59 S NINA STCORTLAND, IL, 601124047Browse IL providers · Browse ZIP 60112
- Phone
- 8157937737
- Primary Specialty
-
Massage Therapist
225700000X
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.