Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LANE DAVID DIECKOW
ActiveLANE DAVID DIECKOW is a Physical Therapy Assistant healthcare provider located in PEORIA, Illinois. NPI 1467690073 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · PEORIA, IL
Registration Details
- NPI Number
- 1467690073
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 4, 2009 (17.530542126313 yrs)
- Last Updated
- Jun 28, 2017
- License
-
070016884 (IL)
Practice Information
- Address
-
3714 N PROSPECT RDPEORIA, IL, 616147743Browse IL providers · Browse ZIP 61614
- Phone
- 3095507888
- Fax
- 3095507848
- Primary Specialty
-
Physical Therapy Assistant
225100000X
Other Physical Therapy Assistant Providers in PEORIA, IL
| Name | Credential | NPI |
|---|---|---|
| LISA D GUMMERMAN | PT | 1366413551 |
| ANTHONY J RAPPLEAN | PT | 1588636682 |
| J D NIMRICK | PT | 1154393254 |
| ERIC GLOW | PT | 1558336123 |
| PENNY GRIFFITH | PT | 1134194715 |
| CHERYL GODFREY | PT | 1265407845 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.