Mida N Bautista-Dittmar, PT

NPI #1982714010 in Peru, Illinois

Provider Information

NPI Number: 1982714010
Entity Type: Individual
Name: Mida N Bautista-Dittmar, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Aug 30, 2006
Last Updated: Jan 14, 2009

Practice Location

Address: 1627 4TH ST
City: Peru
State: Illinois
ZIP Code: 61354-3507
Phone: (815) 223-4479

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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