Provider Demographics
NPI:1932432044
Name:RAMSETH, DIANA (PTA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:RAMSETH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:DINA
Other - Middle Name:
Other - Last Name:RAMSETH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:4044 E SWEETWATER AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-6739
Mailing Address - Country:US
Mailing Address - Phone:602-481-4110
Mailing Address - Fax:
Practice Address - Street 1:4044 E SWEETWATER AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-6739
Practice Address - Country:US
Practice Address - Phone:602-481-4110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0080A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant