Individual
DIANE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8267 113TH ST, SEMINOLE, FL 33772-4128
(727) 871-9773
Mailing address
8608 PINETREE DR S, SEMINOLE, FL 33772-3337
(727) 392-1724
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4193
FL
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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