Provider Demographics
NPI:1699951780
Name:RICE, DIANE LYNN (DC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:LYNN
Last Name:RICE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 LUCILE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-4703
Mailing Address - Country:US
Mailing Address - Phone:209-406-4505
Mailing Address - Fax:
Practice Address - Street 1:1955 LUCILE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-4703
Practice Address - Country:US
Practice Address - Phone:209-406-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist