Individual
DIANA ELIZABETH COLE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
340 FALCONER DR, COVINGTON, LA 70433
(985) 893-2845
(985) 893-2654
Mailing address
340 FALCONER ST, COVINGTON, LA 70433
(985) 893-2845
(985) 893-2654
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 0700
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT0700
PT LICENSE NUMBER
LA
Enumeration date
12/07/2006
Last updated
07/08/2007
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