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Individual

KRISTIN DIEHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12276 SAN JOSE BLVD STE 508, JACKSONVILLE, FL 32223-8618
(904) 886-3228
(904) 886-3297
Mailing address
202 AQUARIUS CIR N, JACKSONVILLE, FL 32216-1510
(904) 886-3228
(904) 886-3297

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT23212
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT23212
PHYSICAL THERAPIST
FL
Enumeration date
04/17/2007
Last updated
07/08/2007
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