Individual
DIANE MARICE PAWLICZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
75 FOURWING CT, CORRALES, NM 87048-8927
(505) 977-8871
(505) 792-2836
Mailing address
75 FOURWING CT, CORRALES, NM 87048-8927
(505) 977-8871
(505) 792-2836
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2804
NM
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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