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Individual

DIANE M RAKOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
250 CETRONIA ROAD, SUITE 303, ALLENTOWN, PA 18104-9168
(610) 973-6200
(610) 973-6546
Mailing address
PO BOX 848269, BOSTON, MA 02284-8269
(610) 973-1700
(610) 973-1779

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011733L
PA
2251S0007X
Sports Physical Therapist
PT011733L
PA
2251X0800X
Orthopedic Physical Therapist
MD011733L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0052130
ORTHONET
PA
01
1896402
BLUE SHIELD
PA
01
1896402
FIRST PRIORITY LIFE
01
50052969
CAPITAL BLUE CROSS
PA
01
7926898
AETNA
PA
Enumeration date
09/26/2006
Last updated
07/31/2009
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