Agnes P Dietenberger, PTA, CMT

NPI #1306051743 in Hartford, Wisconsin

Provider Information

NPI Number: 1306051743
Entity Type: Individual
Name: Agnes P Dietenberger, PTA, CMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA, CMT
Enumeration Date: May 11, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1640 E. SUMNER ST.
City: Hartford
State: Wisconsin
ZIP Code: 53027
Phone: (262) 670-4300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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