| NPI | 1205943164 |
|---|---|
| Former Legal Business Name | DIANE A. HAISTEN, DO, LLC |
| Entity Type | Organization |
| Authorized Contact | DIANE A SCHLICK Proprieter 850-584-5876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS7860) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-08-02 |