Organization
DIANE A SCHLICK DO LLC
Active
Other names
Diane A. Haisten, DO, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE A SCHLICK DO (PROPRIETER)
(850) 584-5876
Entity
Organization
Contact information
Practice address
616 S JEFFERSON ST, PERRY, FL 32347-4115
(850) 584-5876
(850) 584-4939
Mailing address
616 S JEFFERSON ST, PERRY, FL 32347-4115
(850) 584-5876
(850) 584-4939
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS7860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
256619200
—
FL
Enumeration date
08/24/2006
Last updated
08/02/2007
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