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Derick Blackson
Rehabilitation Practitioner in Las Vegas, Nevada
NPI 1659785806

Derick Blackson is a Rehabilitation Practitioner based in Oakland, NV. Derick Blackson practices in Las Vegas, NV. The NPI Number for Derick Blackson is 1659785806 and holds a License No. (Nevada).

The current practice location address for Derick Blackson is 3674 N Rancho Dr, Las Vegas, NV and can be reached out via phone at 702-396-2988 and via fax at 510-281-6883.

Location: 3674 N Rancho Dr, Las Vegas, NV, 94607-2720
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Provider Profile Details
NPI Number
1659785806
Provider Name
Derick Blackson
Credential
Provider Entity Type
Individual
Gender
Male
Address
3674 N Rancho Dr, Las Vegas, NV, 94607-2720
Phone Number
702-396-2988
Fax Number
510-281-6883
Provider Enumeration Date
06/16/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1114270832 05 NV
institution
Provider Business Practice Location Address Details
Address
3674 N Rancho Dr
City
State
Zip
89130-3110
Phone Number
702-396-2988
Fax Number
510-281-6883
person
Provider Business Mailing Address Details
Address
3674 N Rancho Dr
City
State
Zip
89130-3110
Phone Number
702-396-2988
Fax Number
510-281-6883
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Rehabilitation Practitioner
Speciality
-
Taxonomy
License No.
()
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
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