Individual
DEREK TEDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7359412-2401
UT
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
05/14/2015
Last updated
08/02/2022
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