Provider Demographics
NPI:1992982656
Name:DERR, DEBORAH L (DC)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:L
Last Name:DERR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BILLMAN LN
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-4102
Mailing Address - Country:US
Mailing Address - Phone:406-222-7982
Mailing Address - Fax:
Practice Address - Street 1:101 BILLMAN LN
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-4102
Practice Address - Country:US
Practice Address - Phone:406-222-7982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT890CHI111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition