# DIANE A SCHLICK DO LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Diane A. Haisten, DO, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205943164
- **Authorized official:** DIANE A SCHLICK DO (PROPRIETER)
- **Authorized official phone:** (850) 584-5876

## Contact information

- **Practice address:** 616 S JEFFERSON ST, PERRY, FL 32347-4115
- **Practice address phone:** (850) 584-5876
- **Practice address fax:** (850) 584-4939
- **Mailing address:** 616 S JEFFERSON ST, PERRY, FL 32347-4115
- **Mailing address phone:** (850) 584-5876
- **Mailing address fax:** (850) 584-4939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS7860 | FL | Yes |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 08/02/2007