Provider Demographics
NPI:1215199807
Name:MULLER, DIERDRE LEIGH (PT)
Entity Type:Individual
Prefix:
First Name:DIERDRE
Middle Name:LEIGH
Last Name:MULLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DIERDRE
Other - Middle Name:LEIGH
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:162 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03781-5241
Mailing Address - Country:US
Mailing Address - Phone:603-252-2020
Mailing Address - Fax:
Practice Address - Street 1:2600 WILSON ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5094
Practice Address - Country:US
Practice Address - Phone:406-233-2719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2118PT2251X0800X
NH24922251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic