Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Derek Nystrom, PTA

Individual provider Physical Therapy Assistant · NPI 1801397187

Mr. Derek Nystrom, PTA is a Physical Therapy Assistant in Eau Claire, Wisconsin. Works from 2 locations. Licensed in Wisconsin.

Licensed in
WI
In the registry since
2018
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1109 W Clairemont Ave
Eau Claire, WI 54701-6105
Phone: (715) 717-5367
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2509 County Highway I, Chippewa Falls, WI 54729-2785 — (715) 717-7455

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2176-19 (WI)

Record details

NPI number1801397187
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedFebruary 22, 2018
Last updated in NPPESDecember 29, 2021
Certification dateDecember 29, 2021

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