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Organization
DEREK WISTON, LLC
Active
Organization
DEREK WISTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK WISTON OTR/L (OWNER)
(561) 504-1725
Entity
Organization
Contact information
Practice address
11671 ISLAND LAKES LN, BOCA RATON, FL 33498-6802
(561) 504-1725
(561) 465-2986
Mailing address
11671 ISLAND LAKES LN, BOCA RATON, FL 33498-6802
(561) 504-1725
(561) 465-2986
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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