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Derick Blackson
NPI 1659785806 · on the registry since 2014 · sole proprietor
Practice
- Address
- 3674 N Rancho Dr
101
Las Vegas, NV 89130 - Phone
- (702) 396-2988
- Fax
- (510) 281-6883
- Organisation at this address
- Bpt Phase2 Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 14
Registry record
- Primary taxonomy
- 225400000X
225400000X
- Sex
- Male
- Record last updated
- 2014-06-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Nevada