Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gary Mitchell Van Derveer, LMT

Individual provider Massage Therapist · NPI 1528639960

Gary Mitchell Van Derveer, LMT is a Massage Therapist in Phoenix, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2021
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

3935 E Greenway Rd Apt 205
Phoenix, AZ 85032-4671
Phone: (602) 497-7422
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MT-14602 (AZ)

Record details

NPI number1528639960
Entity typeIndividual (Type 1)
GenderMale
Credentials LMT
Sole proprietorYes
NPI enumeratedJuly 7, 2021
Last updated in NPPESJuly 7, 2021
Certification dateJune 11, 2021
Mailing addressGary M. Van Derveer, 3935 E. Greenway Rd Apt. 205, Phoenix, AZ 85032-4671

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