Individual
VICTORIA FUNK-DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA, RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1620499
CO
225200000X
Physical Therapy Assistant
Primary
12305
CO
Other
Enumeration date
05/15/2012
Last updated
12/19/2013
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