Provider Demographics
NPI:1053740860
Name:POST, DIANE (PTA)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:POST
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-2045
Mailing Address - Country:US
Mailing Address - Phone:269-781-4251
Mailing Address - Fax:269-781-8420
Practice Address - Street 1:879 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-2045
Practice Address - Country:US
Practice Address - Phone:269-781-4251
Practice Address - Fax:269-781-8420
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502001713225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant