Individual
DIANE NULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
67 S TERRACE AVE, NEWARK, OH 43055-1355
(740) 522-3160
(740) 522-3141
Mailing address
3425 EXECUTIVE PKWY, SUITE 128, TOLEDO, OH 43606-1326
(419) 537-0764
(419) 537-0948
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01761
OH
Other
Enumeration date
08/14/2006
Last updated
07/08/2007
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