Derrickson, Brandt

Derrickson, Brandt is an individual health care provider with primary practice located at 1155 W Parkview St Ste 2D , Bolivar MO 65613-7800. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Derrickson, Brandt can be contacted via phone (417) 777-2663.

Contact Information

Primary practice address
1155 W Parkview St Ste 2D Bolivar MO 65613-7800
Phone: (417) 777-2663
Fax: (417) 326-2666
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 2016004534 Missouri

Profile Details

NPI number 1932650736
LBN Legal business name Derrickson, Brandt
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2016
Last updated Oct 18th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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