Individual provider · Type 1 NPI
Derrick D. Ditzler, LMT
Massage Therapist · Cortland, IL
NPI number
1174806590
Active
Practice location
59 S Nina St
Cortland, IL 60112-4047
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | 227012825 (IL) |
Massage Therapist: 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.
About NPI 1174806590
Derrick D. Ditzler, LMT's National Provider Identifier is 1174806590, issued on Sep 21, 2011. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Cortland, IL. The record was last updated on Sep 21, 2011.