Diane Alice Wilson, RPT
Individual provider Active NPI Mechanotherapist · Stanberry, MO
NPI 1821295049 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1821295049
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mechanotherapist 172M00000X
- License
- MO00988 (MO)
- Practice address
- 307 N Pineview St
Stanberry, MO 64489-1509 - Phone
- (660) 783-2118
- NPI assigned
- Jun 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO00988 | MO | MD | Mechanotherapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MO00988 | MO | Yes |
Addresses
Primary practice location
307 N Pineview St
Stanberry, MO 64489-1509
Mailing address
307 N Pineview St
Stanberry, MO 64489-1509
Phone (660) 783-2118
Other providers in Stanberry, MO
- Fallon L Stiens
- TLC Care Center, Inc
- Kylee Townsend
- Tri- County Health Department
- Tri-County Health Department
All providers in Stanberry, MO · Mechanotherapist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.