Individual
DR. DEREK TYLER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
8410 W THOMAS RD STE 136, PHOENIX, AZ 85037-3374
(623) 247-4478
Mailing address
11528 S 53RD AVE, LAVEEN, AZ 85339-4523
(480) 559-4863
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-033905
AZ
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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