Individual
MRS. DIANE SUE MUIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
102 W CLEVELAND AVE, VINTON, VA 24179-3312
(540) 981-1665
Mailing address
3319 FLEETWOOD AVE, ROANOKE, VA 24015-4633
(540) 989-6474
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
#000000347112
VA
174400000X
Specialist
Primary
#0131000745
VA
174400000X
Specialist
AA347112
VA
Other
Enumeration date
02/24/2013
Last updated
02/24/2013
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