Nystrom, Derek

Nystrom, Derek is an individual health care provider with primary practice located at 1109 W Clairemont Ave , Eau Claire WI 54701-6105. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Nystrom, Derek can be contacted via phone (715) 717-5367.

Contact Information

Primary practice address
1109 W Clairemont Ave Eau Claire WI 54701-6105
Phone: (715) 717-5367
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 2176-19 Wisconsin

Profile Details

NPI number 1801397187
LBN Legal business name Nystrom, Derek
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2018
Last updated Dec 29th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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