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Contact Information

ANDREW DIECKMANN, PT, DPT, LAT, ATC
1700 S BROADWAY ST STE E
MOORE, OK73160-5302
 Phone: 405-735-8777
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
 

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for ANDREW DIECKMANN · (Male)

NPI # 1821573478
Status Active
Credentials PT, DPT, LAT, ATC
Entity Individual
Enumeration date 09/30/2018
Last updated 08/11/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2019026347
  • OK License # 6231
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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