NPI 1104955889

Mary E Derck, ATC

Practitioner Athletic Trainer Toledo, OH

Practice location

Address: 2865 N Reynolds Rd STE. 110, Toledo, OH 43615-2068
Phone: (419) 578-7530
Mailing address: 6602 Dorr St APT 202, Toledo, OH 43615-4238

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT.002401 (OH)

Other Specialist/Technologist providers in Ohio →

Registry record

NPI: 1104955889
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Mar 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.