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1376845214
MARTIN JOSEPH DIEDRICH
FORT WAYNE, IN
NPI
1376845214
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IN 32001469A)
Enumeration Date
2010-11-29
Last Update Date
2010-11-29
Business Address
Mr. MARTIN JOSEPH DIEDRICH COTA
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 180-036-0838
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Mailing Address
Mr. MARTIN JOSEPH DIEDRICH COTA
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 180-036-0838
Copy
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