MRS. Diane Burnickas, L/PTA

NPI #1508135369 in Worth, Illinois

Provider Information

NPI Number: 1508135369
Entity Type: Individual
Name: MRS. Diane Burnickas, L/PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: L/PTA
Enumeration Date: Dec 23, 2011
Last Updated: Dec 23, 2011

Practice Location

Address: 6807 W 114TH ST
City: Worth
State: Illinois
ZIP Code: 60482-2012
Phone: (708) 671-0858

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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