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1720395023
DEREK VANDERROEST
PRESCOTT, AZ
NPI
1720395023
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: AZ 9028A)
Enumeration Date
2010-09-08
Last Update Date
2010-09-08
Business Address
-- DEREK VANDERROEST PTA
3117 STILLWATER DR
PRESCOTT, AZ 86305-7164
Phone number: 928-442-0005
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Mailing Address
-- DEREK VANDERROEST PTA
3117 STILLWATER DR
PRESCOTT, AZ 86305-7164
Phone number:
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