Individual
DIANA JANE SOUDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2200 EAST WASHINGTON STREES, BLOOMINGTON, IL 61701
(309) 662-3311
(309) 862-4754
Mailing address
2200 EAST WASHINGTON STREES, BLOOMINGTON, IL 61701
(309) 662-3311
(309) 862-4754
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.001913
IL
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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