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1114743101
DEREK TYLER WILSON
PHOENIX, AZ
NPI
1114743101
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: AZ LPT-033905)
Enumeration Date
2024-11-25
Last Update Date
2024-11-25
Business Address
Dr. DEREK TYLER WILSON PT, DPT
8410 W THOMAS RD STE 136
PHOENIX, AZ 85037-3374
Phone number: 623-247-4478
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Mailing Address
Dr. DEREK TYLER WILSON PT, DPT
11528 S 53RD AVE
LAVEEN, AZ 85339-4523
Phone number: 480-559-4863
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