Provider Demographics
NPI:1356361463
Name:ALBERS, DIANA SUSANNE (AT, ATC)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:SUSANNE
Last Name:ALBERS
Suffix:
Gender:F
Credentials:AT, ATC
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:SUSANNE
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:10224 HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-6916
Mailing Address - Country:US
Mailing Address - Phone:616-403-5416
Mailing Address - Fax:
Practice Address - Street 1:3333 96TH AVE
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-9721
Practice Address - Country:US
Practice Address - Phone:616-748-3129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer