Individual
MRS. DONNA GAIL DIEDRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
104 MARSHALL ST, FORT MILL, SC 29715-1816
(803) 547-6817
(803) 547-2708
Mailing address
104 MARSHALL ST, FORT MILL, SC 29715-1816
(803) 547-6817
(803) 547-2708
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
1697
SC
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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