LARRY R DIEDIKER

CONROE, TX
NPI1245244615
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TX  ATO170)
Enumeration Date2006-07-28
Last Update Date2007-07-08
Business Address
-- LARRY R DIEDIKER L.A.T.
508 MEDICAL CENTER BLVD
CONROE, TX 77304-2808
Phone number: 936-760-6631
Mailing Address
-- LARRY R DIEDIKER L.A.T.
13240 CREST DR
WILLIS, TX 77318-6611
Phone number: 396-228-5035
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