DEREK VANDERROEST

PRESCOTT, AZ
NPI1720395023
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: AZ  9028A)
Enumeration Date2010-09-08
Last Update Date2010-09-08
Business Address
-- DEREK VANDERROEST PTA
3117 STILLWATER DR
PRESCOTT, AZ 86305-7164
Phone number: 928-442-0005
Mailing Address
-- DEREK VANDERROEST PTA
3117 STILLWATER DR
PRESCOTT, AZ 86305-7164
Phone number: