Individual
DIANE SCOTTI VERMAELEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, ATC, LAT, FIS
Contact information
Practice address
4920 PINEHILL DR, BATON ROUGE, LA 70817-2368
(225) 751-5126
Mailing address
15476 RYAN AVE, PRAIRIEVILLE, LA 70769
(225) 938-0797
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
J00065
LA
225200000X
Physical Therapy Assistant
Primary
PTA1983
LA
2255A2300X
Athletic Trainer
000090406
—
Other
Enumeration date
03/09/2007
Last updated
09/23/2015
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