Doctor Name: | MR. DEREK SOOHOO |
NPI Number: | 1679917223 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT MMP |
License Number: | 7392 |
Business Practice Address: | 250 Jackson St 4th Floor Lowell, MA - 018522106 |
Business Phone Number: | 9783763899 |
Business Fax Number: | |
Mailing Address: | 78 Davis Rd, CHELMSFORD |
State: | MA |
Postal Code: | 018241302 |
Phone Number: | 9783763899 |
Fax Number: | |
NPI Enumeration Date: | 04/25/2013 |
NPI Last Update Date: | 04/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 7392 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |