Individual
DEREK T DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
99 W MARTIAL AVE, LAFAYETTE, LA 70508-6583
(337) 962-3461
(337) 330-2024
Mailing address
417 GORDON CROCKET DR, LAFAYETTE, LA 70508-5162
(337) 962-3461
(337) 330-2024
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LA01589
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LA01589
LA STATE BOARD OF PHYSICAL THERAPIST
LA
Enumeration date
07/06/2006
Last updated
06/14/2022
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