Individual
SHAYLEE BREANN DIEDIKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 OTTAWA RD, NEODESHA, KS 66757-1897
(620) 325-2611
Mailing address
16820 HIGHWAY 146, ERIE, KS 66733-4185
(620) 605-8860
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-03630
KS
Other
Enumeration date
01/19/2021
Last updated
12/01/2022
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