MARTIN JOSEPH DIEDRICH

FORT WAYNE, IN
NPI1376845214
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IN  32001469A)
Enumeration Date2010-11-29
Last Update Date2010-11-29
Business Address
Mr. MARTIN JOSEPH DIEDRICH COTA
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 180-036-0838
Mailing Address
Mr. MARTIN JOSEPH DIEDRICH COTA
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 180-036-0838