Individual
DERRICK J O'GARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
32655 TAYLOR GRADE RD, DUETTE, FL 34219-7916
(712) 209-5015
Mailing address
32655 TAYLOR GRADE RD, DUETTE, FL 34219-7916
(712) 209-5015
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA27078
FL
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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