Provider Demographics
NPI:1306034152
Name:DIZON, RAMONITA (OTR)
Entity Type:Individual
Prefix:
First Name:RAMONITA
Middle Name:
Last Name:DIZON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2536 W INDUSTRIAL PARK DR STE 11
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-2634
Mailing Address - Country:US
Mailing Address - Phone:812-825-3730
Mailing Address - Fax:
Practice Address - Street 1:2536 W INDUSTRIAL PARK DR STE 11
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-2634
Practice Address - Country:US
Practice Address - Phone:812-825-3730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist