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1356663926
DEREK IVAN THUESON
PROVO, UT
NPI
1356663926
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: UT 7525850-2401)
Enumeration Date
2010-02-23
Last Update Date
2010-02-23
Business Address
-- DEREK IVAN THUESON PT
1034 N 500 W
PROVO, UT 84604-3380
Phone number: 801-357-2299
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Mailing Address
-- DEREK IVAN THUESON PT
PO BOX 30180
SALT LAKE CITY, UT 84130-0180
Phone number:
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