Individual
MR. CHARLES DIETRICH GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5922 CATTLEMEN LANE, SUITE 100, SARASOTA, FL 34232
(941) 378-8977
(941) 378-8967
Mailing address
5922 CATTLEMEN LANE, SUITE 100, SARASOTA, FL 34232
(941) 378-8977
(941) 378-8967
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19756
FL
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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