NPI 1255162111 · live from the CMS NPI Registry
Derrick Wilson, MT
Massage Therapist in Washington, DC. National Provider Identifier 1255162111, active.
NPI record
| NPI | 1255162111 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 2701 Ontario Rd Nw, Washington, DC 20009 |
| Practice phone | 202-299-9005 |
| Mailing address | 883 Clopper Rd Apt A4, Gaithersburg, MD 20878 |
| Enumerated | August 12, 2024 |
| Last updated | August 12, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | MT2457 (DC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.