Individual
DEREK THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
724 24TH AVE NW, NORMAN, OK 73069-6218
(405) 447-1571
Mailing address
724 24TH AVE NW, NORMAN, OK 73069-6218
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2008
OK
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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