Provider Demographics
NPI:1255668026
Name:VERNIER, DEREK DEAN (PT)
Entity Type:Individual
Prefix:MR
First Name:DEREK
Middle Name:DEAN
Last Name:VERNIER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5428 FLINTWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8493
Mailing Address - Country:US
Mailing Address - Phone:850-637-2873
Mailing Address - Fax:
Practice Address - Street 1:5428 FLINTWOOD CIR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8493
Practice Address - Country:US
Practice Address - Phone:850-637-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-15
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist