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NPI Code Detail

MEDICARE: CHRISTIAN M DIAZ PT, DPT

MEDICARE:   CHRISTIAN M DIAZ  PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical TherapistPT022736PA

General Provider Information

NPI Number : 1457788754
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN M DIAZ PT, DPT
Provider Business Mailing Address
First Line : 304 MCKEAN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19148-2630
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2311 COTTMAN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19149-1007
Country : US
Telephone Number : 215-331-3414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2013
Last Update Date : 10/01/2013

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Directions to “ CHRISTIAN M DIAZ PT, DPT” Practice Location

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