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NPI 1073596425

NPI 1073596425 : JULIE ANN DIAB PT : HINGHAM, MA

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General NPI Number Information
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    NPI Number           |    1073596425
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    Entity Type          |    Individual 
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    Provider Name        |    JULIE ANN DIAB PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/21/2005
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    Last Update Date     |    04/22/2009
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Provider Practice Location Address
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    Address Line         |    205 LINDEN PONDS WAY 
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    City                 |    HINGHAM
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    State                |    MA
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    Zip                  |    02043-8714
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    Country              |    US
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    Telephone            |    781-534-7160
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    Fax                  |    781-534-7382
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Provider Business Mailing Address
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    Address Line         |    205 LINDEN PONDS WAY 
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    City                 |    HINGHAM
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    State                |    MA
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    Zip                  |    02043-8714
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    Country              |    US
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    Telephone            |    781-534-7160
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    Fax                  |    781-534-7382
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    15670
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    License Number State |    MA
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