Provider Demographics
NPI:1023019148
Name:GARMAN, DIANE LOTTEN (RN, DC)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:LOTTEN
Last Name:GARMAN
Suffix:
Gender:F
Credentials:RN, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 FAIRPORT VILLAGE LNDG
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-1804
Mailing Address - Country:US
Mailing Address - Phone:585-377-5890
Mailing Address - Fax:
Practice Address - Street 1:142 FAIRPORT VILLAGE LNDG
Practice Address - Street 2:
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-1804
Practice Address - Country:US
Practice Address - Phone:585-377-5890
Practice Address - Fax:585-377-5899
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7978493OtherAETNA
NY657961OtherACN
NYC10725-2 WOtherWORKER'S COMP
NYC10725-2 WOtherWORKER'S COMP
NYDD6798Medicare ID - Type Unspecified