Individual
DIANE WALZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1751 VICTORY BLVD, STATEN ISLAND, NY 10314-3513
(718) 816-6111
Mailing address
5327 18TH AVE, BROOKLYN, NY 11204-1523
(718) 831-2333
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
11/15/2017
Last updated
03/17/2018
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