Provider Demographics
NPI:1184877599
Name:MAGAARD, DEREK THOMAS (BS)
Entity type:Individual
Prefix:MR
First Name:DEREK
Middle Name:THOMAS
Last Name:MAGAARD
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Gender:M
Credentials:BS
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Mailing Address - Street 1:521 BROADWAY AVENUE NORTH
Mailing Address - Street 2:PO BOX 287
Mailing Address - City:BRAHAM
Mailing Address - State:MN
Mailing Address - Zip Code:55006
Mailing Address - Country:US
Mailing Address - Phone:320-396-3333
Mailing Address - Fax:320-396-3363
Practice Address - Street 1:521 BROADWAY AVENUE NORTH
Practice Address - Street 2:FIVE COUNTY MENTAL HEALTH CENTER - BRAHAM OFFICE
Practice Address - City:BRAHAM
Practice Address - State:MN
Practice Address - Zip Code:55006
Practice Address - Country:US
Practice Address - Phone:320-396-3333
Practice Address - Fax:320-396-3363
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner