NPI 1003225392

Craig Diss, PTA

Practitioner Physical Therapy Assistant Fort Wayne, IN

Practice location

Address: 2625 Creeping Phlox Cv, Fort Wayne, IN 46818-8942
Phone: (260) 450-4828

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 06004292A (IN)

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Registry record

NPI: 1003225392
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Aug 2014
Record last updated: 12 Aug 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.