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1518319375
DEREK WILLARD
TAMPA, FL
NPI
1518319375
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: FL PTA25631)
Enumeration Date
2016-07-05
Last Update Date
2016-07-05
Business Address
Mr. DEREK WILLARD PTA
6918 GUNN HWY
TAMPA, FL 33625-3853
Phone number: 813-774-6911
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Mailing Address
Mr. DEREK WILLARD PTA
1200 LEXINGTON GREEN LN
SANFORD, FL 32771-1013
Phone number:
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