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General NPI Number Information
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NPI Number | 1043272602
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Entity Type | Individual
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Provider Name | DIANA M PADILLA MS, ATC, EMT
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Gender | Female
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 500 VETERANS WAY
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City | TEMPE
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State | AZ
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Zip | 85287-0001
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Country | US
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Telephone | 480-965-9430
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Fax | 480-965-8224
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Provider Business Mailing Address
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Address Line | 500 VETERANS WAY
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City | TEMPE
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State | AZ
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Zip | 85287-0001
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Country | US
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Telephone | 480-965-9430
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Fax | 480-965-8224
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 373
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License Number State | NM
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