Individual
MRS. DIANE ALICIA EZERNACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1414 FERN CREEK DR, STATESVILLE, NC 28625-9376
(828) 459-6824
(828) 655-2344
Mailing address
PO BOX 5105, BELFAST, ME 04915-5100
(919) 220-5255
(919) 220-6971
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P23026
NC
225100000X
Physical Therapist
PT32489
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P23026
PT LICENSE
NC
Enumeration date
03/06/2007
Last updated
03/27/2025
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