Individual
DEREK GODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2424 N WYATT DR STE 130, TUCSON, AZ 85712-6119
(520) 784-6570
(520) 784-6575
Mailing address
PO BOX 31630, TUCSON, AZ 85751-1630
(520) 784-6200
(520) 784-6109
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-006081
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
604842
—
AZ
Enumeration date
10/25/2019
Last updated
01/23/2020
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