Individual
MS. DIANE MARIE CUSTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
512 E MONROE DR UNIT D431, FORT COLLINS, CO 80525-2796
(994) 036-8829
Mailing address
PO BOX 271498, FORT COLLINS, CO 80527-1498
(994) 036-8829
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0011886
CO
225100000X
Physical Therapist
1017598
TX
Other
Enumeration date
04/10/2007
Last updated
03/07/2013
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