Individual
MR. DERRICK S TIPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5939 GALL BLVD., ZEPHYRHILLS, FL 33542
(816) 932-3315
Mailing address
8730 N HIMES AVE APT 1209, TAMPA, FL 33614-8308
(813) 481-8632
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 23080
FL
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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