Mr Derrick D Ditzler, LMT is a
Massage Therapist based in Cortland, Illinois. Mr Derrick D Ditzler is licensed to practice in Illinois (license number 227012825) and his current practice location is
59 S Nina St, Cortland, Illinois. He can be reached at his office (for appointments etc.) via phone at
(815) 793-7737.
NPI number for Mr Derrick D Ditzler is 1174806590 and his current mailing address is 59 S Nina St, Cortland, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1174806590.
Healthcare Provider's Profile
| Full Name | Mr Derrick D Ditzler |
|---|
| Gender | Male |
|---|
| Speciality | Massage Therapist |
|---|
| Location | 59 S Nina St, Cortland, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1174806590
- Provider Enumeration Date: 09/21/2011
- Last Update Date: 09/21/2011
Medical Identifiers
Medical identifiers for Mr Derrick D Ditzler such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174806590 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225700000X | Massage Therapist | 227012825 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Derrick D Ditzler is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Derrick D Ditzler, LMT
59 S Nina St,
Cortland, IL 60112-4047
Ph: (815) 793-7737 | Mr Derrick D Ditzler, LMT
59 S Nina St,
Cortland, IL 60112-4047
Ph: (815) 793-7737 |
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