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Individual

MS. DIANNE SWANSON GAINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
927 S STATE ROAD 19, PALATKA, FL 32177-9397
(386) 336-9028
Mailing address
125 RIVERS EDGE DR, EAST PALATKA, FL 32131-4310
(386) 328-3030

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 0003378
FL
225100000X
Physical Therapist
FL
2251P0200X
Pediatric Physical Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
881063000
FL
Enumeration date
06/19/2006
Last updated
04/23/2020
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