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Individual

CAROL ANN DIEHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3003 HIGHWAY 95, SUITE 61, BULLHEAD CITY, AZ 86442
(928) 758-0029
(928) 758-0055
Mailing address
2225 LARIAT DR, BULLHEAD CITY, AZ 86442-8802
(928) 758-6014
(928) 758-0055

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1526
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0693
LICENSURE
NV
01
1526
LICENSURE
AZ
01
20870
LICENSURE
CA
01
247
LICENSURE
WY
Enumeration date
09/25/2006
Last updated
07/08/2007
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