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Diana Ickes, PTA
Other Specialist/Technologist in Riverview, Florida
NPI 1669923496

Diana Ickes is a Other Specialist/Technologist based in Riverview, FL. Diana Ickes practices in Riverview, FL and has the professional credentials of PTA. The NPI Number for Diana Ickes is 1669923496 and holds a License No. PTA17336 (Florida).

The current practice location address for Diana Ickes is 11458 Captiva Kay Dr, Riverview, FL and can be reached out via phone at 941-812-8159.

Location: 11458 Captiva Kay Dr, Riverview, FL, 33569-2057
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669923496
Provider Name
Diana Ickes
Credential
PTA
Provider Entity Type
Individual
Gender
Female
Address
11458 Captiva Kay Dr, Riverview, FL, 33569-2057
Phone Number
941-812-8159
Fax Number
Provider Enumeration Date
10/17/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
11458 Captiva Kay Dr
City
Riverview
State
Florida
Zip
33569-2057
Phone Number
941-812-8159
Fax Number
person
Provider Business Mailing Address Details
Address
11458 Captiva Kay Dr
City
Riverview
State
Florida
Zip
33569-2057
Phone Number
941-812-8159
Fax Number
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist, Other
Speciality
-
Taxonomy
246Z00000X
License No.
PTA17336 (Florida)
Definition
General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines.
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