Individual
MARI DOLORES DIECKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
125 E ELM AVE, SUITE 103, FLAGSTAFF, AZ 86001-3258
(928) 213-9730
(928) 213-9732
Mailing address
125 E ELM AVE, SUITE 103, FLAGSTAFF, AZ 86001-3258
(928) 213-9730
(928) 213-9732
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2093
AZ
2251X0800X
Orthopedic Physical Therapist
2093
AZ
Other
Enumeration date
01/04/2007
Last updated
08/01/2014
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