Individual
DEREK A WASNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
12265 TOWNSEND RD, PHILADELPHIA, PA 19154
(215) 671-9200
Mailing address
2430 E BOSTON ST, PHILADELPHIA, PA 19125
(215) 858-9599
(215) 689-4090
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
30043
CA
225100000X
Physical Therapist
40QA01099200
NJ
225100000X
Physical Therapist
Primary
PT017145
PA
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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