Individual
DYLAN EVAN DEDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
765 W NASA BLVD, MELBOURNE, FL 32901-1815
(321) 733-5725
Mailing address
2000 FARM POND RD, BALDWINSVILLE, NY 13027-9062
(845) 901-3798
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT37927
FL
Other
Enumeration date
02/01/2023
Last updated
02/01/2023
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