Provider Demographics
NPI:1427647841
Name:DIEHL PHYSICAL THERAPY & WELLNESS, LLC
Entity type:Organization
Organization Name:DIEHL PHYSICAL THERAPY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RAINY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:907-602-9551
Mailing Address - Street 1:6305 CONNORS TRAIL CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-2106
Mailing Address - Country:US
Mailing Address - Phone:907-602-9551
Mailing Address - Fax:
Practice Address - Street 1:6305 CONNORS TRAIL CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-2106
Practice Address - Country:US
Practice Address - Phone:907-602-9551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy