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Contact Information

NICHOLAS J DERENZIS
400 S INDEPENDENCE AVE
INDEPENDENCE, VA24348
 Phone: 276-773-0303
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for NICHOLAS J DERENZIS · (Male)

NPI Number 1720476757
Status Active
Credentials
Entity Individual
Enumeration date 12/29/2014
Last updated 07/25/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • VA License # 2305205303
  • WA License # PT 60386876
  • WV License # PT003561
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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