Northrup, Derrick

Northrup, Derrick is an individual health care provider with primary practice located at 605 Taylor Ln , Chubbuck ID 83202-5169. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Northrup, Derrick can be contacted via phone (208) 221-6952.

Contact Information

Primary practice address
605 Taylor Ln Chubbuck ID 83202-5169
Phone: (208) 221-6952
Fax: (844) 946-0909
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT1280 Idaho

Profile Details

NPI number 1124196340
LBN Legal business name Northrup, Derrick
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 4th, 2006
Last updated Mar 20th, 2020 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1124196340 NPPES
Idaho MEDICAID 805245100
Idaho Other T6939

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