Diana Jane Souder, P.T.

NPI #1790033306 in Bloomington, Illinois

Provider Information

NPI Number: 1790033306
Entity Type: Individual
Name: Diana Jane Souder, P.T.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Credential: P.T.
Enumeration Date: Aug 29, 2012
Last Updated: Aug 29, 2012

Practice Location

Address: 2200 EAST WASHINGTON STREES
City: Bloomington
State: Illinois
ZIP Code: 61701
Phone: (309) 662-3311

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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