Individual
KESIA DERILUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
814 E CAMP WISDOM RD, DUNCANVILLE, TX 75116-2828
(214) 217-0303
Mailing address
12660 HILLCREST RD APT 6201, DALLAS, TX 75230-2028
(954) 560-0951
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2144804
TX
Other
Enumeration date
10/16/2021
Last updated
10/16/2021
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