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General NPI Number Information
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NPI Number | 1528237682
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Entity Type | Individual
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Provider Name | DEREK PAUL WRIGLEY M.T.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2008
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Last Update Date | 02/22/2008
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Provider Practice Location Address
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Address Line | 1500 BAKER ST UNIT C
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City | BAKERSFIELD
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State | CA
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Zip | 93305-3771
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Country | US
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Telephone | 661-717-3521
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Fax |
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Provider Business Mailing Address
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Address Line | 800 NEW STINE RD APT 66
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City | BAKERSFIELD
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State | CA
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Zip | 93309-2967
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Country | US
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Telephone | 661-717-3521
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2007-400 POEM
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License Number State |
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