Derek Authier, LMT

NPI #1497151955 in Blaine, Minnesota

Provider Information

NPI Number: 1497151955
Entity Type: Individual
Name: Derek Authier, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Nov 11, 2014
Last Updated: Feb 27, 2015

Practice Location

Address: 10705 TOWN SQUARE DR NE
City: Blaine
State: Minnesota
ZIP Code: 55449-8184
Phone: (651) 491-7176

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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