Individual
DERRICK WINTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1347 CATHERINE ST, WILLIAMSPORT, PA 17701-2513
(570) 329-6850
Mailing address
1347 CATHERINE ST, WILLIAMSPORT, PA 17701-2513
(570) 329-6850
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004797
PA
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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