Derrick Michael Brantley, LMT
NPI #1477006195 in Orange City, Florida
Provider Information
- NPI Number
- 1477006195
- Entity Type
- Individual
- Name
- Derrick Michael Brantley, LMT
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Massage Therapist
- Credential
- LMT
- Enumeration Date
- Jul 28, 2016
- Last Updated
- Jul 28, 2016
Practice Location
- Address
- 572 HAMILTON AVE
- City
- Orange City
- State
- Florida
- ZIP Code
- 32763-4610
- Phone
- (386) 801-0642
Specialties & Taxonomy Codes
| Specialty |
|---|
| Massage Therapist |
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