DEREK NYSTROM

EAU CLAIRE, WI
NPI1801397187
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WI  2176-19)
Enumeration Date2018-02-22
Last Update Date2021-12-29
Business Address
MR. DEREK NYSTROM PTA
1109 W CLAIREMONT AVE
EAU CLAIRE, WI 54701-6105
Phone number: 715-717-5367
Mailing Address
MR. DEREK NYSTROM PTA
24405 COUNTY HIGHWAY F
NEW AUBURN, WI 54757-5346
Phone number:
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