Individual
MS. DIANE WEIDEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
29882 LOY DR, MENIFEE, CA 92585-9147
(951) 285-6193
Mailing address
29882 LOY DR, MENIFEE, CA 92585-9147
(951) 285-6193
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6093
CA
Other
Enumeration date
02/05/2017
Last updated
02/05/2017
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