Individual
DEREK DEWITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1509 FAIRMONT AVE, FAIRMONT, WV 26554-2135
(304) 363-0050
(304) 363-0048
Mailing address
PO BOX 727, FAIRMONT, WV 26555-0727
(304) 363-0050
(304) 363-0048
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003986
WV
225100000X
Physical Therapist
P18077
NC
Other
Enumeration date
06/25/2018
Last updated
09/29/2020
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