Individual
CARL PETER DEROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1485 N TURQUOISE DR, SUITE 220, FLAGSTAFF, AZ 86001-1398
(928) 774-6626
Mailing address
3285 S SKYE WAY, FLAGSTAFF, AZ 86001-9142
(928) 779-4461
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
0767
AZ
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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