Provider Demographics
NPI:1659399616
Name:FELTMAN, DIANE C (RPT)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:C
Last Name:FELTMAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:C
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:8021 KNUE RD
Mailing Address - Street 2:STE. 112
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-1974
Mailing Address - Country:US
Mailing Address - Phone:317-841-7005
Mailing Address - Fax:
Practice Address - Street 1:8021 KNUE RD
Practice Address - Street 2:STE. 112
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1974
Practice Address - Country:US
Practice Address - Phone:317-841-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05001552A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist