| Doctor Name: | DIANE JANICKI |
| NPI Number: | 1306008081 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.P.T |
| License Number: | 218 |
| Business Practice Address: | 140 Commerce Dr Green River, WY - 829356178 |
| Business Phone Number: | 3078758492 |
| Business Fax Number: | 3078757389 |
| Mailing Address: | Po Box 1497, GREEN RIVER |
| State: | WY |
| Postal Code: | 829351497 |
| Phone Number: | 3078758492 |
| Fax Number: | 3078757389 |
| NPI Enumeration Date: | 06/25/2008 |
| NPI Last Update Date: | 06/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 218 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |