Moore, Derryck Vancurk
Moore, Derryck Vancurk is an sole proprietor health care provider with primary practice located at 12400 25Th Ave N , Plymouth MN 55441-4008. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Moore, Derryck Vancurk can be contacted via phone (612) 220-8645.Contact Information
Primary practice address
12400 25Th Ave N
Plymouth MN 55441-4008
Phone: (612) 220-8645
Fax: (952) 405-8090
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 301674 | Minnesota |
Profile Details
| NPI number | 1336381599 |
|---|---|
| LBN Legal business name | Moore, Derryck Vancurk |
| Credentials | LADC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 1st, 2009 |
| Last updated | Apr 1st, 2009 - about 17 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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