MRS. Diane Lisabeth Blagojevich, P.T.

NPI #1386961779 in Redondo Beach, California

Provider Information

NPI Number: 1386961779
Entity Type: Individual
Name: MRS. Diane Lisabeth Blagojevich, P.T.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: P.T.
Enumeration Date: Apr 26, 2010
Last Updated: Apr 26, 2010

Practice Location

Address: 510 N PROSPECT AVE
Address 2: SUITE 105
City: Redondo Beach
State: California
ZIP Code: 90277-3028
Phone: (310) 372-4646

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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