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DIANE M ERNEWEIN PT
>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1265611354
Individual Registrant: DIANE M ERNEWEIN PT
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
4112 OUTLOOK BLVD STE 96 PUEBLO, CO 81008-1667 US
Tel: 719-562-6200 Fax: --
Tel: 719-562-6200 Fax: --
Contact information for business:
4112 OUTLOOK BLVD STE 96 PUEBLO, CO 81008-1667 US
Tel: 719-562-6200 Fax: --
Tel: 719-562-6200 Fax: --
Registration Information:
NPI: 1265611354
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | CO | CO 2899 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 60929871 | CO | 05 |
