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Mr. Derrick A Powell, LMT
Massage Therapist in Round Lake, Illinois
NPI 1487390084

Derrick A Powell is a Massage Therapist based in Round Lake, IL. Derrick A Powell practices in Round Lake, IL and has the professional credentials of LMT. The NPI Number for Derrick A Powell is 1487390084 and holds a License No. 227022514 (Illinois).

The current practice location address for Derrick A Powell is 586 S Rosehall Ln, Round Lake, IL and can be reached out via phone at 847-505-6944.

Location: 586 S Rosehall Ln, Round Lake, IL, 60073-4268
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487390084
Provider Name
Derrick A Powell
Credential
LMT
Provider Entity Type
Individual
Gender
Male
Address
586 S Rosehall Ln, Round Lake, IL, 60073-4268
Phone Number
847-505-6944
Fax Number
Provider Enumeration Date
05/07/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
586 S Rosehall Ln
City
Round Lake
State
Illinois
Zip
60073-4268
Phone Number
847-505-6944
Fax Number
person
Provider Business Mailing Address Details
Address
586 S Rosehall Ln
City
Round Lake
State
Illinois
Zip
60073-4268
Phone Number
847-505-6944
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
227022514 (Illinois)
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.
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