Individual
MS. DIANA JEAN TANNOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT ASSISTANT
Contact information
Practice address
7807 BAYMEADOWS RD E, SUITE 200, JACKSONVILLE, FL 32256-9664
(904) 398-4133
(904) 398-4148
Mailing address
3565 LONE TREE LN, JACKSONVILLE, FL 32216-2241
(904) 646-0627
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA20182
FL
Other
Enumeration date
03/10/2009
Last updated
03/10/2009
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