Individual
JENNIFER R DIEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 CHESAPEAKE DR, TARPON SPRINGS, FL 34689-2515
(727) 934-4629
Mailing address
5312 17TH AVE S, GULFPORT, FL 33707-4211
(727) 599-7797
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28927
FL
Other
Enumeration date
12/11/2018
Last updated
12/11/2018
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