Individual provider · Type 1 NPI

Derek Marc Provencher, PT, DPT

Physical Therapist · Tampa, FL

NPI number 1114609245 Active

Practice location

16037B Tampa Palms Blvd W
Tampa, FL 33647-2001

Call (813) 542-8188 Map

Mailing address

9309 Persimmon Brook Trl Apt 215
Thonotosassa, FL 33592-3963

Specialties and licenses

TaxonomyCodeLicense
Physical Therapist Primary 225100000XPTT40333

Physical Therapist: Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, r…

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About NPI 1114609245

Derek Marc Provencher, PT, DPT's National Provider Identifier is 1114609245, issued on Aug 7, 2023. The primary taxonomy on file is Physical Therapist (225100000X), and the practice location is in Tampa, FL. The record was last updated on Aug 15, 2023.